A Practical Technique for Reduction of the Bony Nasal Dorsum Height Using Kazanjian Bone-Cutting Forceps.

Abstract

Resection of the nasal hump is one of the most critical steps of the rhinoplasty procedure, which is quite prone to complications when performed improperly or inappropriately. In this article, a practical, facile and minimally traumatic hump resection technique using Kazanjian bone-cutting forceps is presented with excellent cosmetic and functional results. Fifty-seven consecutive primary (septo-)rhinoplasty patients with wide nasal bases, and various sizes of nasal humps, were enrolled in the study. Following reduction of the cartilaginous dorsum height, L-strut shaping of the septum, and septoplasty procedures, Kazanjian bone-cutting forceps were used for resection of the bony nasal hump. Lateral osteotomies were then performed, and the surgery was completed following insertion of the structural grafts, tip procedures and turbinate surgery. A computer software was used to measure the nasal hump. The "Rhinoplasty Outcome Evaluation" questionnaire was used to evaluate patient satisfaction 12months after the operation. The technique presented here was performed on 19 male and 38 female patients with a mean age of 24.95±6.07years. The mean height of the nasal hump was 4.65±1.56mm. No patient had complications requiring further corrective surgery. The "Rhinoplasty Outcome Evaluation" questionnaire showed that all patients remained in the group of happy subjects. Long-term patient satisfaction indicates that the proposed technique could be used as an alternative procedure to other hump resection techniques. The technique described is an effective, reliable and atraumatic method of resection of any size nasal hump. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .