Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection
- Authors
- Rho, Bong Il; Lee, In Ho; Park, Eun Soo
- Issue Date
- Jan-2016
- Publisher
- 대한성형외과학회
- Keywords
- Rhinoplasty; Osteotomy; Ecchymosis; Dissection
- Citation
- Archives of Plastic Surgery, v.43, no.1, pp 88 - 92
- Pages
- 5
- Journal Title
- Archives of Plastic Surgery
- Volume
- 43
- Number
- 1
- Start Page
- 88
- End Page
- 92
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/9462
- DOI
- 10.5999/aps.2016.43.1.88
- ISSN
- 2234-6163
2234-6171
- Abstract
- 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.
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