Prominent Chicago Facial Reconstructive Surgeon Dr. Dean Toriumi Develops New Techniques for Managing the Deviated Nose

    MARINA DEL REY, CA, January 23, 2010 /24-7PressRelease/ -- Often a deviated nose results from injury or trauma, and the nasal septum is frequently the underlying problem in the deviated nose. A deviated nose may also have a deviated septum that blocks the nasal airway.

Without proper correction of a deviated nose - enabled by reconstruction of a deviated septum - residual nasal deviation or nasal obstruction may occur, said Dean Toriumi, M.D., a facial plastic surgeon in the Division of Facial Plastic and Reconstructive Surgery and Department of Otolaryngology - Head & Neck Surgery at the University of Illinois at Chicago.

"Many surgeons correct the deviated nose by shifting the nasal bones and manipulating more superficial cartilage structures. They treat noses in this fashion because they may feel uncomfortable deconstructing the nose and then reconstructing the nasal septum," Toriumi said. "Unfortunately, superficial correction performed without correcting the underlying septal deviation can leave the patient with a residual crooked nose and persistent nasal airway obstruction."

"The nasal septum acts as the foundation of the nose. If the foundation of the nose is left in a deviated state then the patient is more likely to have a residual nasal deviation or nasal obstruction. In fact, correction of the crooked nose deformity is commonly unsuccessful and some report failure rates over 50%," Toriumi added.

Toriumi's expertise in functional and aesthetic nasal surgery is tied to his initial training as an otolaryngologist, where he learned how to perform advanced surgery on the nasal septum before his advanced training in facial plastic and reconstructive surgery.

Toriumi's approach to success in correcting the deviated or crooked nose involves correction and reconstruction if needed of any and all deviations of the nasal septum. This requires a thorough understanding of the nasal anatomy, adequate material for reconstruction, and knowledge of advanced techniques that can be used to completely rebuild the nasal septum. Toriumi is an expert in the use of costal, or rib cartilage, which provides abundant amounts of cartilage for nasal and septal reconstruction. Toriumi initially published a paper on subtotal septal reconstruction in 1994 in The Laryngoscope, an otolaryngology medical publication. For years, he had developed techniques of reconstructing severe deviations of the nasal septum. Over the years Toriumi has refined his techniques of septal reconstruction using costal cartilage, which allows him to reconstruct most any septal deformity.

Toriumi's methods of aesthetic and functional rhinoplasty have helped to evolve the technique of subtotal septal reconstruction. "I've worked hard to correct nasal functional problems and hone the aesthetics," Toriumi said. "In this technique, I reconstruct the nasal septum by creating a straight L-shaped septal strut that can then support the nasal structure itself. Reconstruction of the L-shaped septal strut requires adequate cartilage, but ear cartilage is frequently not strong enough to create a stable L-strut. Using costal cartilage I have developed methods to cut very thin costal cartilage grafts that can be used in septal reconstruction and not bend, warp, or block the nasal airway," adding that he has developed and refined these methods and has many years of experience sharpening them.

Figure above shows septal reconstruction. A shows how a segment of cartilage is used to replace the caudal aspect of the nasal septum. B shows the completed septal reconstruction.

After reviewing many of his cases treating the deviated nose, Dr. Toriumi found that his success rate treating the deviated nose is quite high, as is correction of nasal airway obstruction.

Treatment of the deviated nose is much more difficult than treating a straight nose. Surgeons who are not well versed in correcting severe septal deviations are less likely to be successful in treating the deviated nose. Unfortunately, once a patient undergoes an unsuccessful surgery to straighten a nose, revision surgery is even more complex, Toriumi said.

First of all, valuable septal cartilage that could have been used to perform the reconstruction is no longer available, requiring the use of costal cartilage for the revision surgery. "Many surgeons will try to use injectable filler materials in the nose in an effort to create the appearance of a straight nose," Toriumi noted. "But use of injectable fillers in the nose is very risky and can result in infection and damage to the skin and vascular supply to the nose. Once this type of damage occurs, attaining a normal nose may no longer be possible."

For more information on repairing deviated septums, please contact:

Dr. Dean Toriumi
312) 255-8812
60 East Delaware Place, Suite 1460
Chicago, IL 60611

or for an appointment, please email Pat Goldman, RN. at [email protected] or visit our website at: http://deantoriumi.com/.

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