Noses of the Middle East: Variety of Phenotypes and Surgical Approaches.

[BACKGROUND] The Middle East (ME) proper, a vast area between the East coast of the Mediterranean Sea and Afghanistan, is populated by many nations and tribes. Several nose phenotypes are prevalent throughout the region, but there is no published study encompassing and exploring nose phenotypes encountered in the various countries and subregions of the ME.

[METHODS] The current study was based on the analysis of compiled data from 1207 patients of ME origin (53% of my total rhinoplasty patient cohort) operated by the author during the years 1985 to 2015. Among them 1046 (86.5%) underwent primary rhinoplasty and 161 (13.5%) were previously operated elsewhere, almost all in the ME.

[RESULTS] The following nose subtypes were defined according to the data gathered during the duration of this study in the computerized medical charts and photo archives: Egyptian, Levantine, Turkish (Anatolian), oriental Turkish (Götürks of Central Asian origin), Iraqi, Kurdish, and Persian. From 1985 to 1994, 30% of my patients were of ME origin, from 2001 to 2013 60% and since 2014 65%. Prevalence of various ethnic origins among the patients seeking for rhinoplasty in Sweden was studied. Most frequently represented ethnic groups were quoted in the order of largest prevalence: Assyrians, Iraqis, Kurds, and Iranians. Technical peculiarities concerning surgery on the various ethnic groups were described.

[CONCLUSION] Noses of Middle Eastern populations exhibit some similarities, but also broad phenotypic variation. Consequently, there is no single typical Middle Eastern nose, although large size, prominent arched dorsum, and a naso-labial angle ≤90° are common.