Septal Reposition and Correction of a Deviated Nose Using a Nasal Wedge Bone Graft after Osteotomy in Corrective Rhinoplasty

다국어 초록 (Multilingual Abstract)

Background Patients with deviated nose frequently present concomitant nasal bone as well as septal deviation. Many surgical methods have been developed to address such septal deviation, along with various osteotomy techniques to correct bone deviation. The authors performed medial and paramedian osteotomies to treat deviated nose with mild hump, and utilized the acquired wedge shaped bone graft to achieve septal reposition and bony vault correction.
Methods From October 2014 through June 2015, 10 patients with nasal bone deviation that showed sufficient lateral nasal wall angle but deviated dorsum and septum on their preoperative facial computed tomography were included in this study. The authors performed open rhinoplasty to expose the planned osteotomy site, and conducted medial and paramedian osteotomy that resulted in the separation of a wedge-shaped bone fragment. Bony septum deviation was then treated with the swing door maneuver, and the resected 2 to 3 mm portion of the nasal bone was stabilized by inserting the wedge-shaped bone graft acquired from the previous osteotomy procedures. Consecutive clinical examinations were followed on postoperative 1, 3, and 6 months to observe any recurrences.
Results All patients were satisfied with their surgical results, and no recurrent deviations were noted.
Conclusions Precise bone resection and transposition is essential for a successful corrective rhinoplasty. However, medial and lateral osteotomy are not mandatory procedures in all cases, and the nasal wedge bone graft that was utilized to support the treated septal bone may have aided in sustaining the surgical correction.

참고문헌 (Reference)

1 Seneldir S, "Unilateral osteotomies for external bony deviation" 21 : 1890-1893, 2010

2 Demirbilek N, "Two-level septocolumellar suture technique for correction of septal caudal dislocation" 2015

3 Cil Y, "The crooked nose: the use of medial iliac crest bone graft as a supporting framework" 19 : 1631-1638, 2008

4 Bridger GP, "Split rib graft for alar collapse" 107 : 110-113, 1981

5 Nassif P, "Rhinoplasty and bony vault complications" 28 : 303-309, 2012

6 Cil Y, "Radial bone graft usage for nasal septal reconstruction" 44 : 36-40, 2011

7 Bloom JD, "Osteotomies in the crooked nose" 27 : 456-466, 2011

8 Dini GM, "Grafts for straightening deviated noses" 128 : 529e-537e, 2011

9 Sadooghi M, "Extended osteocartilaginous spreader graft for reconstruction of deviated nose" 146 : 712-715, 2012

10 Sheen JH, "Achieving more nasal tip projection by the use of a small autogenous vomer or septal cartilage graft. A preliminary report" 56 : 35-40, 1975

11 Kim JK, "A simple technique for correcting the hump on a deviated nose" 30 : 686-688, 2006