Darwish, Y., Raafat, S., Ezzat, S., El Kholy, Y., Aboul Nasr, L. (2021). Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), 319-325. doi: 10.21608/ejprs.2021.201656
Yasmine G Darwish; Sarah S Raafat; Sherif Z Ezzat; Yusuf A El Kholy; Laila A Aboul Nasr. "Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome". The Egyptian Journal of Plastic and Reconstructive Surgery, 45, 4, 2021, 319-325. doi: 10.21608/ejprs.2021.201656
Darwish, Y., Raafat, S., Ezzat, S., El Kholy, Y., Aboul Nasr, L. (2021). 'Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome', The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), pp. 319-325. doi: 10.21608/ejprs.2021.201656
Darwish, Y., Raafat, S., Ezzat, S., El Kholy, Y., Aboul Nasr, L. Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome. The Egyptian Journal of Plastic and Reconstructive Surgery, 2021; 45(4): 319-325. doi: 10.21608/ejprs.2021.201656
Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome
The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt
Abstract
Background: Many techniques are described for performing lateral osteotomies with the external perforating and the continuous internal methods being the most common. Osteotomy remains challenging, being done blindly and associated with morbidities. In this study a new simple approach for lateral osteotomy is described. This technique aims at achieving more precise osteotomy outcomes with a short learning curve and with morbidity reduction, in terms of edema and ecchymosis. Patients and Methods: A prospective, single-arm case series study is conducted on 20 patients seeking primary rhinoplasty. A periosteal incision is done and subperiosteal dissection is performed at the level of the proposed osteotomies. The osteotome is anchored under vision to the edge of the nasal bone and the osteotomy is performed along the proposed site till the radix. Follow-up visits with photography are at day two, day ten then at three weeks, two months, and three months. Results: Upon assessing the post-operative course of our cases, sixteen patients (80%) developed grade I edema, which resolved completely by the 3rd post-operative day. Eighteen patients (90%) did not complain of any ecchymosis in the post-operative period. An accelerated learning curve was noticed through shorter intraoperative time 42% downtime, easy replication of technique and better results. Conclusion: This technique of lateral osteotomies enables a higher degree of control for the fracture line with short learning curve and easy reproducibility. Furthermore, the amount and the duration of post-operative complications in terms of edema and ecchymosisare minimal.
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