In rhinoplasty, the 'osseocartilaginous vault' refers to the middle third of the nose. A 'open roof deformity' occurring after hump reduction is caused by which specific structural problem, and how is it corrected?
- A Excessive resection of the lower lateral cartilages; corrected by cartilage grafting
- B Deviated nasal septum; corrected by septoplasty
- C Separation of the upper lateral cartilages from the septum after dorsal hump reduction; corrected by spreader grafts ✓
- D Over-resection of the nasal tip; corrected by columellar strut graft
Correct answer: C. Separation of the upper lateral cartilages from the septum after dorsal hump reduction; corrected by spreader grafts
Explanation
An 'open roof deformity' occurs when dorsal hump reduction separates the upper lateral cartilages (ULCs) from the nasal septum, leaving a wide flat dorsum without the normal convex 'roof.' This disrupts the internal nasal valve angle (normally 10–15°) and causes both cosmetic deformity (flat, wide nasal bridge) and functional obstruction. It is corrected by placing spreader grafts — cartilage grafts placed between the septum and ULCs to reconstruct the internal nasal valve and restore the natural dorsal curvature. This is a fundamental rhinoplasty concept.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.