We present a rare case of iatrogenic saddling of the nose in a 63-year-old man. Because he was bilaterally aphakic after cataract extractions in the 1950s without intraocular lens implants, his subsequent spectacle prescription of +17 diopters rendered his glasses so heavy that prolonged wear had caused a large indentation to his nasal bridge (figure). He was entirely untroubled by this, both functionally and cosmetically; therefore, no attempt at surgical correction was considered.
Due to advances in surgical technique as well as intraocular and spectacle lens technology, the requirement for aphakic spectacles is increasingly rare. However, both otolaryngologists and ophthalmologists should be aware of the potential for saddlenose deformity in their patients.
Various degrees of dorsal saddling and nasal deformity may also result from rhinoplasty,' Wegener's granulomatosis, relapsing polychondritis,' leprosy and syphilis,'and neoplasms.* Cocaine use also causes structural compromise, via vasoconstriction-mediated necrosis of the perichondrium and subsequent chondrocyte death.^

Foda HM. External rhinoplasty: A critical analysis of 500 cases. J Laryngol Otol 2003;117(6):473-7.

Trenthani DE, Le CH. Relapsing polychondritis. Ann Inleni Mcd 1998;129(2):l 14-22.
Dyer WK 2nd, Beaty MM. Prabhat A. Architectural deficiencies of the nose. Otolaryngol Clin North Am Í999;32(1):89-I12.

Cleary KR, Batsakis |G. Sinonasal lymphomas. Ann Olol Rhinol Laryngol 1994;103(11):911-14.
Hélie F, Fournier ]. Destructive lesions of the median line second- ary to cocaine abuse. J OtolaryngoI 1997;26(1):67-69.