One-Unit Osteotomy to Correct Deviated Bony Dorsum.

Clin Exp Otorhinolaryngol

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Published: February 2023

AI Article Synopsis

  • A crooked nose often results from nasal bony vault deviation, and effectively managing this issue is crucial in rhinoplasty procedures. The study introduces a one-unit osteotomy technique that combines different surgical approaches to achieve better symmetry in the nasal bones.
  • In a study involving 20 patients who underwent this new one-unit osteotomy, outcomes were evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and by measuring the angle of bony vault deviation pre- and post-operation.
  • Results showed significant improvements in both functional and aesthetic outcomes, with a greater percentage reduction in deviation angles for the one-unit osteotomy (70.3%) compared to conventional methods (56.6%),

Article Abstract

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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985986PMC
http://dx.doi.org/10.21053/ceo.2022.01095DOI Listing

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