A dorsal hump is a common prominence on the bridge of the nose, composed of bone and cartilage. This profile can result from genetics, previous trauma, or natural growth during puberty. A frequent concern is whether this external bump negatively affects the ability to breathe. This article explores the anatomical relationship between the dorsal hump and the internal nasal passages to determine its impact on airflow.
Understanding Nasal Anatomy and the Dorsal Hump
The nasal dorsum, or bridge, is the external structure where the dorsal hump is situated. This prominence is formed by the bony-cartilaginous framework where the paired nasal bones meet the upper lateral cartilages. While the hump defines the outer contour, breathing function is governed by the architecture of the internal nasal cavity.
Airflow navigates this internal space, divided into two passages by the nasal septum—a wall of bone and cartilage. Within each passage are the turbinates, three pairs of scroll-like structures that warm, humidify, and filter inhaled air. The narrowest area for breathing is the anterior nasal valve, located just inside the nostril. The dorsal hump itself is positioned well outside of this internal pathway.
The Correlation Between External Humps and Internal Airflow Restriction
A dorsal hump is an external feature and does not typically restrict airflow on its own. Breathing function relies on the patency of the internal nasal valves and the straightness of the septum. Therefore, reducing an isolated hump for purely aesthetic reasons should not change breathing function.
However, a strong correlation exists because the same forces that create a hump often compromise internal structures concurrently. Trauma, such as a fracture, can cause the bone and cartilage to heal with a visible bump while simultaneously causing the internal septum to shift. This resulting condition is a deviated septum, which directly blocks the internal airway and is a frequent cause of breathing difficulty.
Structural issues stemming from excessive growth can also affect both the external and internal nose. For instance, an overdeveloped septal cartilage can push upward, contributing to the dorsal hump formation. This excessive growth often leads to significant septal deviation lower down, reducing the space for air passage. Consequently, the breathing restriction is caused not by the visible hump, but by the associated internal deviation or a narrowing of the nasal valve area.
Functional Diagnosis and Treatment Options
If a patient reports both a dorsal hump and difficulty breathing, a specialist must first distinguish between the aesthetic concern and the functional issue. A consultation with an otolaryngologist or a facial plastic surgeon involves a physical examination to assess the internal nasal structures. Diagnostic tools like nasal endoscopy allow the surgeon to visualize the septum and turbinates directly, while a Computed Tomography (CT) scan provides detailed imaging of the underlying bony and cartilaginous framework.
The treatment approach is tailored to the root cause of the breathing problem. If the obstruction is solely due to a deviated septum, a Septoplasty is performed to straighten the internal wall and improve airflow. If the aesthetic dorsal hump is the primary concern, a Rhinoplasty is performed to reshape the external profile.
When a patient has both a functional issue, like a deviated septum, and an aesthetic concern, a combined procedure known as Septorhinoplasty is often recommended. During this operation, the surgeon corrects the internal deviation and reduces the external hump in a single operation. Hump reduction necessitates careful structural reconstruction to prevent a severe complication called nasal valve collapse. Removing the cartilage and bone can destabilize the mid-vault of the nose, requiring the placement of cartilage grafts, known as spreader grafts, to maintain the width of the internal nasal valve and ensure long-term breathing function.