I have a very tall, thin nose with a large dorsal hump. I have had difficulties with breathing for years now, and at long last I have received a referral to the hospital. My surgeon stated that it would be a good way forward to have Septoplasty and turbinate Rhinoplasty surgery first to see if this shall help my breathing. Because I have a very tall thin nose, I think this surgery shall have no real effect because the side of my nose will still close in towards the centre, thus affecting my breathing. Any advice?
Dorsal Hump Removal to Improve Breathing?
Doctor Answers 5
Rhinoplasty is considered cosmetic
A rhinoplasty will not help with the breathing out of your nose. However, a septoplasty and/or turbinate surgery will help with the breathing component of your nasal function. A rhinoplasty can be performed at the same time as the breathing surgery but is not covered by any medical insurance.
It won't help correct your airway.
See a rhinoplasty expert who is familiar with airway problems to correct any septal or turbinate problem. Removing the hump won't improve your nasal airway.
Hump Removal Will Not Improve Your Breathing
In fact in cases of a relatively thin nose with a projecting dorsum removal of the hump may adversely affect the nasal airway unless other corrective steps are taken by an experienced rhinoplasty surgeon.
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Proper airway evaluation
Nasal airway obstruction is a very complex issue. The correction depends on proper initial diagnosis. Diagnosis, Diagnosis, Diagnosis!
To diagnose the problem a thorough history is important.
1) Is your breathing bad all the time or only certain times of day?
2) Are both sides affected equally?
3) Does the obstruction shift from side to side?
4)What if anything that you do yourself improves the breathing (i.e. Breath-rite strips, afrin, tip elevation with your finger, etc?)
The areas of obstruction can be due to the septum, the inferior or middle turbinates, the nostrils (external valve) or internal valve, etc...
The correction may involve septoplasty, turbinate reduction, alar batten grafts, alar rim graft, spreader grafts, and more....
A tall narrow nose with a hump ends up with an open roof after hump removal which requires breaking the bones (osteotomies) to close the "open roof" which will make the airway even narrower. 60% of airflow goes along the floor of the nose but the rest travels up higher so the diameter of the roof is important. Spreader grafts are crucial to avoid a middle vault collapse in such cases.
What I am getting at is showing you the complexity of nasal airway and proper diagnosis by a surgeon who truly understands the nose is key.
You are correct, the dorsal hump does not play any role in breathing. The turbinated, on the back floor of the nose, can improve breathing if they are reduced in size. When a patient has a tall narrow nose spreader grafts, at the valve area, usually are the largest contributer to improved breathing. Ask about this good luck!