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Facial Plast Surg 2020; 36(01): 057-065
DOI: 10.1055/s-0040-1701478
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Osteotomies—When, Why, and How?

Garrett D. Locketz
1   Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
,
Kirkland N. Lozada
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Penn Medicine Becker ENT, University of Pennsylvania, Philadelphia, Pennsylvania
,
Daniel G. Becker
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Penn Medicine Becker ENT, University of Pennsylvania, Philadelphia, Pennsylvania
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Publikationsdatum:
19. März 2020 (online)

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Abstract

An ideal nasal osteotomy should deliver precise, predictable, and reproducible cosmetic and functional results while minimizing soft-tissue trauma and postoperative complications. In addition to closing an open roof deformity after hump reduction, other common indications for osteotomies include the crooked nose and a wide bony vault. The literature has reported numerous and diverse osteotomy techniques as well as differences in timing of osteotomies. Each has its own merits and indications, and its proponents. In this article, we review the anatomy and nomenclature relating to osteotomies. We review the locations and paths of the osteotomies—lateral, intermediate, medial, and superior/transverse. We consider the percutaneous and endonasal approaches, as well as timing of osteotomies and other considerations. We also discuss technical considerations in the selection of instrumentation for osteotomies.

Keywords

osteotomies - open roof - endonasal - percutaneous