Posttraumatic Rhinoplasty: Is There a Role for Internal Fixation?

This is a controversial topic. As a general principle in craniofacial surgery (notably orthognathic surgery), if a bone is osteotomised and then repositioned, it is usually secured using current plating techniques. The notable exception to this is the nose. With conventional rhinoplasty, stability is often possible using carefully placed osteotomies and varying combinations of external splints, septal splints, nasal packs and relying on the natural elasticity of the repositioned septum to maintain the nose’s position. Whilst in many cases this appears to be perfectly satisfactory, repositioning of the nasal bones does have a relapse rate. In view of this, it would seem logical to consider the role of internal fixation and the circumstances when this could be a useful adjunct. Case selection and techniques are described.