Treating traumatic nasal deformities with osteotomy

摘要

Treating traumatic nasal deformities with osteotomy is relatively difficult compared to ordinary rhinoplasty, because of scarring, skin deficiency, and poor bone support due to comminuted fracture. In cases where the skin envelope is relatively preserved, osteotomy would be a reasonable way to correct the deformity. The osteotomy technique: After minimal dissection at the osteotomized line, osteotomy is begun. I prefer performing percutaneous osteotomy with a 2 mm width chisel through a small incision. Care must be taken not to penetrate the nasal mucosa if possible. Leaving the mucosa intact helps the osteotomized bone to be controlled precisely. After completing the osteotomy, the bone is mobilized gently with the hands and move medially. A plastic splint is applied and no nasal packing is needed. When irregularities of the nasal dorsum still exist, some additional procedure is recommended, such as a septal cartilage graft, or a bone graft. Preoperative evaluation of the skin and bone condition is important in order to obtain good results.