Open osteotomy in rhinoplasty
10.3760/cma.j.cn114453-20210611-00260
- VernacularTitle:直视下开放鼻截骨技术的临床应用
- Author:
Lehao WU
1
;
Jianjun YOU
;
Huan WANG
;
Yihao XU
;
Ruobing ZHENG
;
Xulong ZHANG
;
Le TIAN
;
Junsheng GUO
;
Fei FAN
Author Information
1. 中国医学科学院北京协和医学院整形外科医院鼻整形与再造中心，北京 100144
- Keywords:
Rhinoplasty;
Nose;
Osteotomy;
Surgery, plastic
- From:
Chinese Journal of Plastic Surgery
2022;38(3):321-326
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce a new method of lateral nasal osteotomy. The key of this method is to fully dissect the tissue around the piriform foramen to achieve nasal osteotomy under direct vision. The osteotomy line in the whole process can be seen, which provides a more reliable control for the degree of osteotomy during the operation, and also makes the postoperative outcome more predictable.Methods:Patients whom were treated with open external osteotomy combined with autologous costal cartilage implantation for augmentation rhinoplasty (with 24 cases of hump nose correction) from October 2018 to October 2020. During the surgery, the whole nasal dorsum was exposed, the superior lateral cartilage was separated from the nasal septum, and the whole process was carried out through the mucosa from the intranasal approach under direct view. The osteotomy line was evaluated at the same time.Results:A total of 33 female patients were retrospectively analyzed. All the operations were successful, and the local swelling occurred after operation. The follow-up time was 3-18 months. After 3 months, the nasal contour and dorsal curves were smooth. Severe infections, major injuries like nasolacrimal duct, lacrimal sac, medial canthus ligament, nerve branches were not noticed in all patients. During the long-term follow-up, two patients exhibited slightly widened nasal bone, but did not require surgical intervention. The shape of nose was greatly improved. Patients were satisfied with the result . The subjective evaluation had "very satisfactory" in 24 cases (72.7%) and "satisfactory" in 9 cases (27.3%). The IGAIS evaluation were also positive: the average score of 33 patients was 1.26±0.34, including 30 cases (90.9%) scoring 1 point and 3 cases (9.1%) scoring 2 points.Conclusions:The open osteotomy technique has better control than that of conventional blind operation. It is more reliable, safer for the surgeons who are new to rhinoplasty and the experienced ones.
