Crooked nasal bridge describes the deviation of the nasal dorsum that are typically centrally aligned. Crooked nasal bridge can be better appreciated when we consider the nasal and maxillary bone anatomy that comprise the nasal dorsum contour. The base of the nasal dorsum, called the nasal base, is created by the maxillary bones. The top of the nose, the nasal bridge, is created by thin nasal bones that extend up from the lower maxillary bones. When there is trauma to the nasal dorsum, the nasal and maxillary bones can be fractured resulting in displacement and/or deviation of the nasal and maxillary bones. The crooked nose bridge thus describes the peak of the nasal dorsum that will typically be deviated off of its central alignment following a compression injury.
The crooked nasal bridge thus describes fracture and displacement of the nasal bones specifically. Less affected are the maxillary bones that sit at the base of the nasal dorsum and describes the nasal base. To correct a crooked nose bridge requires displacing the deviated nasal bones and partial maxillary bones back into alignment centrally. When crooked nose bridge is treated early, closed nasal reduction can be used to literally press the bones back into place. When treated in delayed fashion, the nasal and maxillary bones have to be refractured using a formal closed rhinoplasty surgery. When performed in delayed fashion, it is possible to not only correct the crooked nose bridge, but also to narrow a wide nasal bridge, and even remove a nasal dorsum hump. Often a crooked nose bridge is acquired as a child for example following a fall out of bed that is not diagnosed until years later. As a young adult, difficulty breathing may develop which then persuades patients from seeking medical attention. If correction of the crooked nose bridge is pursued, then a closed functional rhinoplasty can be considered which will result in not only correction of the crooked nose bridge but also eliminating the nasal hump and narrowing a widened nasal base. This means not only improvement in breathing but also improved aesthetics of the nasal dorsum contour. If you are concerned about a crooked nose bridge and difficulty breathing, we encourage you to seek a consultation by a nasal specialist.
Please see this 16 year old female crooked nose deformity incurred during soccer. She appreciates her improved contour post rhinoplasty, septoplasty, turbinectomy.