Medial nasal bone trimming for managing the deviated and or wide bony vault in Asians

Chayakorn Phannikul; Dong-Yun Lee; Tae-Bin Won

doi:10.25056/JCM.2023.7.1.13

Original Article

Split Viewer

J Cosmet Med 2023; 7(1): 13-18

Published online June 30, 2023

https://doi.org/10.25056/JCM.2023.7.1.13

Medial nasal bone trimming for managing the deviated and or wide bony vault in Asians

Chayakorn Phannikul, MD¹, Dong-Yun Lee, MD², Tae-Bin Won, MD, PhD²

¹Department of Otorhinolaryngology, Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand
²Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Rep. of Korea

Correspondence to :
Tae-Bin Won
E-mail: bin200@snu.ac.kr

Received: May 8, 2023; Revised: May 30, 2023; Accepted: June 6, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Go to

Abstract
Figure
Reference

Background: Managing the bony vault in rhinoplasty is challenging despite the use of various techniques. High revision rates persist due to recurrent or residual deviations. In severe cases, intermediate osteotomy is difficult in Korean patients due to their shorter and thicker nasal bones.
Objective: Managing the bony vault is challenging in rhinoplasty procedures. This study aimed to evaluate the results of medial nasal bone trimming to correct deviated and wide bony vaults.
Methods: This retrospective study included patients who underwent rhinoplasty with medial nasal bone trimming at a single hospital between June 2010 and June 2013. Medical records including diagnoses, computerized preoperative tomography scans, operation records, intraoperative photographs, postoperative results, and complications were collected. Postoperative aesthetic improvement was evaluated using a 4 point-Likert scale.
Results: Fifty patients were included, of which 31 patients were diagnosed with a deviated nasal dorsum, 12 with a deviated nasal dorsum, and seven with a wide nasal dorsum without deviation. Nasal bone trimming was performed bilaterally and unilaterally in 29 and 21 patients, respectively. Postoperative aesthetic score was 2.31±0.61, 2.57±0.45, and 2.7±0.56 for the patients in the deviated, deviated and wide, and wide without deviated groups, respectively.
Conclusion: Medial nasal bone trimming can be a simple, safe, and effective procedure for achieving symmetry and narrowing of the bony vault in patients with a deviated or wide bony pyramid.

Keywords: nasal bone, nasal dorsum, nose, osteotomy, resection, rhinoplasty

Figures

Go to

Abstract
Figure
Reference

Fig. 1.A schematic drawing of the medial nasal bone trimming on a patient with a deviated bony pyramid. The medial osteotomy (the red dash lines) and lateral osteotomy (the pink dash lines) are accomplished follow by correcting of the central bony pyramid and nasal septum. After the correction, the medial side of the non-deviated side of nasal bone (labeled in grey) is overlapping the central bony pyramid. This part of the nasal bone is trimmed away (the blue dash lines) in a wedge shape with a pair of nasal scissors, decreasing the risk of recurrent nasal deviation by extrinsic force of the overlapping nasal bones.

References

Go to

Abstract
Figure
Reference

Won TB, Kang JG, Jin HR. Management of post-traumatic combined deviated and saddle nose deformity. Acta Otolaryngol 2012;132 Suppl 1:S44-51.
Byrd HS, Salomon J, Flood J. Correction of the crooked nose. Plast Reconstr Surg 1998;102:2148-57.
Hsiao YC, Kao CH, Wang HW, Moe KS. A surgical algorithm using open rhinoplasty for correction of traumatic twisted nose. Aesthetic Plast Surg 2007;31:250-8.
Bloom JD, Immerman SB, Constantinides M. Osteotomies in the crooked nose. Facial Plast Surg 2011;27:456-66.
Lee SH, Yang TY, Han GS, Kim YH, Jang TY. Analysis of the nasal bone and nasal pyramid by three-dimensional computed tomography. Eur Arch Otorhinolaryngol 2008;265:421-4.
Jin HR, Won TB. Nasal hump removal in Asians. Acta Otolaryngol Suppl 2007;558:95-101.
Won TB. Hump nose correction in Asians. Facial Plast Surg Clin North Am 2018;26:357-66.
Jin HR, Lee JY, Shin SO, Choi YS, Lee DW. Key maneuvers for successful correction of a deviated nose in Asians. Am J Rhinol 2006;20:609-14.
Lee PC, Chang RH, Chang YL. Treatment of nasal deviation with underlying bony asymmetry secondary to augmentation rhinoplasty in Asian patients. Aesthet Surg J 2018;38:823-32.
Jin HR, Won TB. Rhinoplasty in the Asian patient. Clin Plast Surg 2016;43:265-79.

Article

Original Article

J Cosmet Med 2023; 7(1): 13-18

Published online June 30, 2023 https://doi.org/10.25056/JCM.2023.7.1.13