2007/02/09 by Ronald P. Gruber, Te Ning Chang, David Kahn +1 · 1 citation
Medicine · Dentistry · #Nasal Surgery and Airway Studies #Facial Rejuvenation and Surgery Techniques #Orthodontics and Dentofacial Orthopedics #Osteotome #Osteotomy #Medicine #Reduction (mathematics) #Nasal bone #Apex (geometry) #Anatomy #Nasal septum #Nose #Surgery #Geometry
paper · doi:10.1097/01.prs.0000252504.65746.18
openalex publication_date 2007/02/09 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
BACKGROUND: A persistent problem with nasal bone osteotomies is inadequate reduction of the width of the nasal dorsum. In addition, an algorithm as to which osteotomy to use has not been fully explored. METHODS: Nine cadavers received a medial oblique osteotomy (15 to 30 degrees off midline) following a humpectomy in six. On one side, the osteotomy was performed on the medial side of the apex of the open roof. On the contralateral side, it was performed on the lateral side of the apex. The osteotome was then pried posteriorly. The resultant hemidorsal widths were compared. Clinically, 53 patients were classified into the following: type I, broad nasal base (lateral osteotomy only); type II, broad nasal base and broad dorsum (lateral and medial oblique osteotomy); and type III, broad dorsum only (medial oblique osteotomy only). RESULTS: The reduction in hemidorsal width was greatest when the osteotome was placed on the lateral side of the apex (t test, p < 0.008). The improved width reduction was attributable to the slippage of the lateral nasal bone under the dorsal hood of the nasal bone. A lateral osteotomy did not have to be performed to reduce the dorsal width alone. After 15 to 32 months, nasal bone width was satisfactory in all but three cases, one of which required a revision. CONCLUSIONS: Reduction of the nasal dorsal width is facilitated by a medial oblique osteotomy alone if it is placed at the lateral aspect of the apex of the open roof. A classification of broad nasal bones is given that emphasizes the distinction between dorsal width and nasal base width and suggests which osteotomy to use.