Saddle Nose

How do I know if I have saddle nose?

The telltale sign of saddle nose is a dip in your nose bridge. This concavity may become more obvious over time.

Some people may develop saddle nose almost immediately, which often happens in cases of trauma. Others may develop signs gradually.

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Other saddle nose symptoms may include:

• Nasal pain or discomfort.
• Nosebleeds (epistaxis).
• Chronic crusting around your nose.
• Turned-up nasal tip.
• Breathing issues.
• Horizontal crease on the lower portion of your nose.
• Nasal septum perforation (when there’s a hole in the cartilage that separates your nostrils).

What causes saddle nose?

Anything that damages your nasal septum can lead to saddle nose deformity. This is because your septum provides structural support for your nose. Some people may be born with saddle nose.

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Specific saddle nose causes include:

• Trauma. A damaged or fractured nose can lead to a breakdown of your septum (the piece of cartilage that separates your nostrils). This is the most common cause of saddle nose deformity.
• Prior nasal surgeries. Septoplasty (surgery to correct a deviated septum) may result in saddle nose deformity. This is particularly true with severe cases of deviated septum.
• Septal hematoma. This refers to a collection of blood in your septum (from trauma or surgery). It can interfere with blood flow to your septum, leading to saddle nose.
• Septal abscess. This happens when infection (pus) collects in your septum. This can also hinder blood flow and cause saddling.
• Vascular and autoimmune diseases. These conditions can cause inflammation in your septum, which can lead to decreased blood flow. As these diseases worsen, your septum may weaken and lead to a sagging nasal bridge.
• Infections. Certain bacterial infections, such as syphilis and Hansen’s disease (leprosy), can affect your bones and cartilage. This may mean your nose doesn’t get enough blood, causing sagging and saddling. Syphilitic saddle nose may be an acquired symptom of syphilis — or you may be born with it.
• Substance use disorder (SUD). Snorting (insufflating) cocaine, methamphetamines, crushed opioid pills or other drugs can damage your nasal structures, leading to saddle nose deformity.

What are the complications of saddle nose?

Saddle nose can cause a number of breathing complications, including:

• Chronic sinus issues.
• Snoring.
• Obstructive sleep apnea.
• A whistling sound when breathing through your nose.

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