Lateral Osteotomy with Sawing Technique in Open Rhinoplasty.

Kim, Youn Hwan; Lee, Hak Sung; Naidu, Shenthilkumar; Kim, Jeong Tae

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(4):499-503.
Published online July 1, 2010.

Lateral Osteotomy with Sawing Technique in Open Rhinoplasty.

Youn Hwan Kim, Hak Sung Lee, Shenthilkumar Naidu, Jeong Tae Kim

¹Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea. younhwank@daum.net
²Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Hospital, Singapore.

Abstract

PURPOSE
Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. METHODS: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously.
RESULTS
This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw.
CONCLUSION
This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

Keywords: Corrective rhinoplasty; Reciprocating saw; Open rhinoplasty; Septoplasty