1 2 the surgeon has to make an accurate planned osteotomy which depends on the type of existing deformity.
Osteotomy to close roof.
Medial osteotomies are generally difficult to perform and should be used judiciously.
In most patients a single lateral osteotomy reaches the expected result with excellent cosmetic outcome good stability and rapid healing.
Abstract lateral osteotomy is a particular step in rhinoplasty that aims to close an open roof deformity after hump reduction narrow the lateral walls of the nose and symmetrically align the nasal bony framework in cases with asymmetry.
The type of anesthesia will depend on what other surgery is being done with the osteotomy.
You may be given general anesthesia to keep you asleep and free from pain during surgery.
Nasal osteotomies are a cornerstone step for closing an open roof deformity after dorsal hump surgery.
Lateral osteotomies are completed in either a low to low or low to high fashion.
Osteotomies consisting of medial intermediate and lateral are usually performed to close an open roof straighten a deviated nose or septum and narrow a wide bony nasal vault.
The remaining steps of rhinoplasty are beyond the scope of this communication.
The medial osteotomy should be used in cases of an extremely wide or deviated nose an iatrogenic open roof difficult to close with a lateral osteotomy an increased bony width above the infraorbital rim and in the presence of thicker nasal bones.
Lateral osteotomy is a very important step in a cosmetic rhinoplasty.
This protocol is performed less often and is preferred for correction of a minor roof opening or mobilization of a moderately wide nasal base 5low to low osteotomy is more powerful as it results in more medial movement of the nasal bone 5therefore the low to low osteotomy is more widely used to correct a large open roof and excessively wide nasal base 5like the low to high approach this procedure also begins low along the piriform aperture and remains low all the way up to the inner canthus.
We are going to focus on the osteotomies.
Notwithstanding the optimal method of nasal osteotomy remains controversial as evidenced by the variety of approaches with no consensus between authors.
Moreover the election of the technique responds to surgeon s preference.
It allows the surgeon to narrow the nose to close the open roof created after hump removal and to achieve symmetry of an asymmetrical nasal bony framework.
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Lateral or base osteotomy lateral osteotomies were first implemented to close an open roof deformity narrow the bony base or lateral walls of the bony pyramid and straighten and correct asymmetric or deviated bony framework.