One-Unit Osteotomy to Correct Deviated Bony Dorsum
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Objectives. A crooked nose is frequently caused by nasal bony vault deviation, and proper management of the bony vaultis an integral part of rhinoplasty. Conventional osteotomy to correct a deviated nose favors simultaneous medial andlateral osteotomies, which allows the free independent movement of each nasal bone. However, patient satisfactionwith deviated nose surgery is sometimes low. In the present study, we introduce a one-unit osteotomy procedure thatcombines bilateral and root osteotomies with unilateral triangular bony wedge resection to allow symmetry of bothnasal bones. Methods. Twenty consecutive patients who presented with bony vault deviation and underwent one-unit osteotomy wereenrolled in this retrospective single-center study. The Nasal Obstruction Symptom Evaluation (NOSE) questionnairewas used to evaluate each patient’s functional outcome. The angle of bony vault deviation before and after one-unitosteotomy was measured using a protractor and compared with the results of 14 patients who had undergone con-ventional osteotomy. The improvement in dorsal deviation was evaluated using facial photography preoperatively and3 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 from6.9°±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 conven-tional 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 esthet-ic 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 removingexcessive bony fragments from the wider bony wall and providing better structural integrity. This technique improvesfunctional outcomes and has equivalent esthetic results to those of the traditional procedure.
Abstract
Objectives. A crooked nose is frequently caused by nasal bony vault deviation, and proper management of the bony vaultis an integral part of rhinoplasty. Conventional osteotomy to correct a deviated nose favors simultaneous medial andlateral osteotomies, which allows the free independent movement of each nasal bone. However, patient satisfactionwith deviated nose surgery is sometimes low. In the present study, we introduce a one-unit osteotomy procedure thatcombines bilateral and root osteotomies with unilateral triangular bony wedge resection to allow symmetry of bothnasal bones. Methods. Twenty consecutive patients who presented with bony vault deviation and underwent one-unit osteotomy wereenrolled in this retrospective single-center study. The Nasal Obstruction Symptom Evaluation (NOSE) questionnairewas used to evaluate each patient’s functional outcome. The angle of bony vault deviation before and after one-unitosteotomy was measured using a protractor and compared with the results of 14 patients who had undergone con-ventional osteotomy. The improvement in dorsal deviation was evaluated using facial photography preoperatively and3 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 from6.9°±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 conven-tional 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 esthet-ic 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 removingexcessive bony fragments from the wider bony wall and providing better structural integrity. This technique improvesfunctional outcomes and has equivalent esthetic results to those of the traditional procedure.
참고문헌 (18)
- Jameson JJ, "High septal osteotomy in rhinoplasty for the deviated nose", Ann Plast Surg, 56(1), pp.40~45 (2006)
- Jang YJ, "Percutaneous root osteotomy for correction of the deviated nose", Am J Rhinol, 21(4), pp.515~519 (2007)
- Gola R, "Functional and esthetic rhinoplasty", Aesthetic Plast Surg, 27(5), pp.390~396 (2003)
- Jin HR, "Rhinoplasty in the Asian patient", Clin Plast Surg, 43(1), pp.265~279 (2016)
- Saban Y, "Dorsal preservation : the push down technique reassessed", Aesthet Surg J, 38(2), pp.117~131 (2018)
- Kang JM, "Modified mattress suturing technique for correcting the septal high dorsal deviation around the keystone area", Am J Rhinol Allergy, 26(3), pp.227~232 (2012)
- Shin J, "Internal nasal valve modification via correction of high dorsal deviation using a modified mattress suture technique", J Clin Med, 11(19), pp.5888~ (2022)
- 류광희, "Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation", Clinical and Experimental Otorhinolaryngology, 11(4), pp.275~280 (2018), 대한이비인후과학회[DOI]
- Okur E, "Outcome of surgery for crooked nose : an objective method of evaluation", Aesthetic Plast Surg, 28(4), pp.203~207 (2004)
- Jin HR, "Key maneuvers for successful correction of a deviated nose in Asians", Am J Rhinol, 20(6), pp.609~614 (2006)
- Choi JW, "One-piece nasal osteotomy for the correction of a centrally deviated nose", Aesthetic Plast Surg, 42(6), pp.1625~1634 (2018)
- Chatrath P, "Objective assessment of facial asymmetry in rhinoplasty patients", Arch Facial Plast Surg, 9(3), pp.184~187 (2007)
- Yi JS, "Frequency and characteristics of facial asymmetry in patients with deviated noses", JAMA Facial Plast Surg, 17(4), pp.265~269 (2015)
- Kosins AM, "Rhinoplasty : the asymmetric crooked nose-an overview", Facial Plast Surg, 32(4), pp.361~373 (2016)
- VanKoevering KK, "Osteotomies demystified", Facial Plast Surg Clin North Am, 25(2), pp.201~210 (2017)
- Sykes JM, "The importance of the nasal septum in the deviated nose", Facial Plast Surg, 27(5), pp.413~421 (2011)
- Patel PN, "A review and modification of dorsal preservation rhinoplasty techniques", Facial Plast Surg Aesthet Med, 22(2), pp.71~79 (2020)
- Choi JE, "The potential esthetic effect of endonasal septoplasty on the cartilaginous dorsum in Asian population", Facial Plast Surg Aesthet Med, 23(1), pp.42~48 (2021)