gms | German Medical Science

Introduction: Traditional hump reduction has been based on “en bloc resection“ of the dorsal hump as an osseo-cartilaginous unit. This includes the resection of the keystone area with the risk of a consecutive collapse and inferior-medial positioning of the remaining upper lateral cartilages (ULCs). If not addressed properly, the consequence would be an inverted-V-deformity and narrowing of the middle vault. Over the past few years, component dorsal hump reduction has become more popular. It allows a step-wise approach in reducing the nasal dorsum with enhanced preservation of the keystone-area.

Method: In a cadaveric study, the authors analyzed the transition of the ULCs during component hump reduction. The cephalic extension beneath the nasal bones was modified and measured.

Results: When the ULCs are released anteriorly from their attachments to the nasal bones at the keystone area and dissected from under the nasal bone, they can be maintained in their integrity during hump reduction.

Conclusions: This manoeuver can allow preservation of the cartilaginous components of the ULCs beyond the keystone area with the potential for a smoother transition line in the keystone are and a straighter aesthetic dorsal profile.

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