Following septoplasty, a patient develops a saddle nose deformity. This complication is most commonly caused by resection of which structure?
- A The dorsal and caudal struts of the quadrilateral cartilage (L-strut) ✓
- B The caudal margin of the quadrilateral cartilage
- C The perpendicular plate of the ethmoid
- D The vomer
Correct answer: A. The dorsal and caudal struts of the quadrilateral cartilage (L-strut)
Explanation
Saddle nose deformity results from loss of dorsal nasal support, which depends on an intact L-strut: the dorsal and caudal (septal) margins of the quadrilateral cartilage. Resection or disruption of this L-strut, particularly the dorsal strut, leads to loss of dorsal height and saddle deformity. The perpendicular plate and vomer provide posterior and inferior support but loss of these alone does not cause saddle nose.
Reference: Cummings Otolaryngology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.