Unilateral Osteotomies for External Bony Deviation
Deviated nose is a term used to describe the deviation of the nasal pyramid from the midline of the face. Despite the many methods applied for correction of the deviated nose, it continues to be one of the most challenging problems in rhinoplasty.
Although there are many techniques devised for that purpose, the recurrence rate of nasal deviation after surgery is still high. Most deviated noses, at the end of a regular rhinoplasty, seem well positioned in the midline. However, the nasal pyramid may begin to migrate to its old position soon. It is important to produce septum, nasal bone, and tip straight individually. There are some techniques to manage nasal bone asymmetry, which are symmetric osteotomy, double osteotomy, and wedge resection. We performed unilateral osteotomy to one side and camouﬂage graft placement to the other side of the nose to correct nasal bone asymmetry in selected patients. The current study examined the usefulness of this technique for deviated noses with nasal bone asymmetry.
Does the open rhinoplasty incision decrease nasal projection?
To evaluate the effects of open rhinoplasty incisions on tip projection using digitized photographs. Thirty-one patients, who underwent open technique rhinoplasty were prospectively included in the study.
The lateral aspect photographs were taken before the operations. Following midcolumellar incision septal elevation was done until septal cartilage was shown. After replacing the skin totally back and suturing midcolumellar incision, the intraoperative photographs were taken The projection indexes were measured by Goode method from the photographs and the measurements were compared. A statistically significant decline of the nasal projection was established after open technique approach. Open rhinoplasty approach led to the decrease of the nasal tip projection. This result was thought to be the effect of ligamentous disruption.