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CC BY-NC 4.0 · Arch Plast Surg 2016; 43(01): 88-92
DOI: 10.5999/aps.2016.43.1.88
Idea and Innovation

Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

Bong Il Rho
Glovi Plastic Surgery, Seoul, Korea
,
In Ho Lee
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
,
Eun Soo Park
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
› Author AffiliationsThe work was supported by the Soonchunhyang University Research Fund.
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There are two general categories of lateral osteotomy techniques—the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

Keywords

Rhinoplasty - Osteotomy - Ecchymosis - Dissection

This article was presented at the 71st International Congress of the Korean Society of Plastic and Reconstructive Surgeons, November 2, 2013 in Seoul, Korea.




Publication History

Received: 02 April 2015

Accepted: 19 October 2015

Article published online:
20 April 2022

© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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