Rhinoplasty for Hypertrophied Transverse Nasalis Muscle: A Case Report

Overview

Nasal deformities have many causes present from birth or acquired later, and the authors state muscular enlargement is an unusual one. They describe a patient with a prominently wide middle vault along with other nasal abnormalities. The widening was thought to come from soft tissue because the area felt thick and firm on examination.

Sections of note

• Single case report; no series, comparison group or numbers beyond the one patient.
• The patient was a 26 year old woman with a prominently wide mid vault and other nasal abnormalities.
• The cause was suspected to be soft tissue because the area was thick and firm to touch.
• Open rhinoplasty was performed, during which enlargement of the paired transverse nasalis muscle was observed.
• The enlarged muscle was removed.
• The authors report a safe postoperative period with excellent cosmetic results.
• They report minimal effect on nasal function in terms of breathing and pronunciation.
• They recommend the approach for patients with similar deformity, citing its simplicity.

What it means for a patient

• A wide middle nose is usually caused by bone and cartilage; muscle enlargement as the cause is described here as unusual.
• The diagnosis was made during surgery, not before it.
• One patient cannot establish how often this occurs or how reliably muscle removal works.
• No follow up duration or objective measurement is reported.

Why this paper matters

Soft tissue causes of nasal width are rarely considered in planning, and a case like this documents one. It records what was found and what was done. Recommending the approach on the basis of a single case is not supported by evidence.

Terms

• Transverse nasalis muscle: the paired muscle running across the bridge of the nose.
• Hypertrophy: enlargement of tissue, here of a muscle.
• Mid vault: the middle third of the nose, between the bony bridge and the tip.
• Open rhinoplasty: surgery through an incision across the columella, lifting the nasal skin.
• Palpation: examining by feel.