Visualized Subperiosteal Internal Lateral Osteotomy in Open Rhinoplasty for Improved Recovery and Outcome

Document Type : Original Article

Authors

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.

Keywords

Main Subjects

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