A History of Nasal Surgery
FROM THE “INDIAN NOSE” TO MODERN SEPTO-RHINOPLASTY
The loss of a nose is considered to be so disfiguring that a person with such an injury would often be excluded from normal community life. This is the reason that even long ago, nasal reconstruction was attempted. The first evidence of such procedures comes from Indian around 600 B.C.; in this case the rebuilding of someone’s nose which had been removed as a form of punishment using skin from the forehead.
Later war-related nose injuries were repaired using flaps of skin surgically removed from the forearm. The first report of this type of operation is in Italy sometime during the 15th century.
Also during this time surgeons attempted to operate to free blocked nasal passages – this was done by burning the inner nose with a glowing hot iron rod. As this method often resulted in disfiguration, infection and intense pain, it could certainly not be described as successful nasal surgery.
At the end of the 19th century, after the introduction of local and general anesthetic as well as surgical methods that could successfully prevent infection, rapid development in the quality of surgery began. More modern types of nose operation were first developed during the beginning of the last century; these changes are inextricably linked with early pioneers in the field such as Freer, Killian and Joseph. In this era nasal surgery was either internal, aiming to improve airflow through the nose, or external to improve the shape of the nose.
The many new discoveries in biology, biochemistry and histology as well as improvements in surgical instruments brought about a second revolution in nasal surgery in the period around the Second World War. This was partly due to more widespread acknowledgement and acceptance of the connection between the function and the external appearance of the nose. Relatedly, often the best strategy for an operation is to address both issues at the same time to correct – a combination surgery that is today known as septo-rhinoplasty. This advancement came about through the work of highly skilled surgeons like Goldmann and Cottle.
As in all surgical fields, there has also been steady improvement in the field of nasal surgery. The marked increase in the number of nose operations being carried out in the last few decades is not only due to technical improvements in procedures – the growing meaning attached to beauty and aesthetics in the culture of today is also a very important factor.