Objectives: A crooked nose is frequently caused by nasal bony vault deviation, and proper management of the bony vault is an integral part of rhinoplasty. Conventional osteotomy to correct a deviated nose favors simultaneous medial and lateral osteotomies, which allows the free independent movement of each nasal bone. However, patient satisfaction with deviated nose surgery is sometimes low. In the present study, we introduce a one-unit osteotomy procedure that combines bilateral and root osteotomies with unilateral triangular bony wedge resection to allow symmetry of both nasal bones.
Methods: Twenty consecutive patients who presented with bony vault deviation and underwent one-unit osteotomy were enrolled in this retrospective single-center study. The Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate each patient's functional outcome. The angle of bony vault deviation before and after one-unit osteotomy was measured using a protractor and compared with the.
Results: of 14 patients who had undergone conventional osteotomy. The improvement in dorsal deviation was evaluated using facial photography preoperatively and 3 months postoperatively.
Results: NOSE values improved from 8.4±6.4 to 4.1±4.2 (P =0.021). The angle of bony vault deviation improved from 6.9°±2.2° to 2.1°±1.2° (P <0.001) in one-unit osteotomy and from 7.3°±4.0° to 2.7°±1.2° (P =0.001) in conventional osteotomy. The preoperative deviation angle improved by 70.3% in one-unit osteotomy compared with 56.6% in conventional osteotomy, which was a significant difference (P =0.033). The mean grade of the postoperative esthetic outcomes for the remaining deviation was 1.6±0.5, which was similar to that in the conventional osteotomy group.
Conclusion: One-unit osteotomy is a relatively simple procedure that balances the width of both lateral walls by removing excessive bony fragments from the wider bony wall and providing better structural integrity. This technique improves functional outcomes and has equivalent esthetic.
Results: to those of the traditional procedure.
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http://dx.doi.org/10.21053/ceo.2022.01095 | DOI Listing |
Pak J Med Sci
December 2024
Ahtesham Khizar, MBBS, FCPS (Neurosurgery), Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Chronic osteomyelitis of the skull base is a commonly reported pathology in existing scientific literature, but chronic osteomyelitis of the skull vault (COSV) is a rarely documented disease. We report the case of a 38 years old Afghan male with a presenting complaint of irregular swelling on the skull vault for six months. The patient had a history of head trauma one year back with a compound depressed fracture which had been surgically managed then.
View Article and Find Full Text PDFChildren (Basel)
November 2024
Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
Background: Cranial vault lesions are common in children, with dermoid and epidermoid cysts being the most frequent. Management is debated due to their slow growth, but early resection can prevent complications and provide a definitive histological diagnosis, which is sometimes linked to systemic diseases.
Methods: A retrospective study of children treated surgically for cranial vault tumors from January 2011 to April 2023 was conducted.
Plast Reconstr Surg
November 2024
Seattle Children's Hospital, Seattle, Washington, USA.
Background: Defining the nature of the unilateral cleft lip and palate nasal deformity (uCLND) and its optimal surgical correction continues to be a challenge. The purpose of this study was to develop a data-driven model of the primary unrepaired osseocartilaginous skeleton of the nasomaxillary complex.
Methods: CT scans of nineteen 3-month-old infants with unrepaired unilateral cleft lip and palate and nineteen age- and race-matched controls were analyzed.
Facial Plast Surg
November 2024
Department of Plastic Surgery, University of California, Irvine School of Medicine, Irvine, California.
Rhinoplasty is undergoing a transformation with the reemergence of dorsal preservation rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "bony dorsal preservation" (BDP), which has particular application for the correction of crooked noses.This comprehensive overview summarizes current DPR concepts and techniques, the intricate considerations that go into the dorsal osseocartilaginous vault and septal management, and how these are modified to treat the crooked nose.
View Article and Find Full Text PDFFacial Plast Surg Clin North Am
November 2024
Saint-Petersburg, Russia.
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