Dorsal preservation septorhinoplasty

Abstract

Nasal dorsum deprojection is avery important tool in functional and aesthetic rhinoplasty. In classic techniques, resection of dorsal bone and cartilage renders dorsal reconstruction necessary. The concept of dorsal preservation rhinoplasty has been known for more than acentury but has experienced arenaissance in recent years, with many critical technical modifications. We present the latest technique of piezo-assisted dorsal preservation rhinoplasty with subdorsal triangular resection and subdorsal Cottle modification based on clinical experience of 205cases. Furthermore, the advantages and disadvantages of this technique are discussed and several other current variations are presented. Piezo-assisted osteotomy enables avery precise fracture line and sparing of periosteum, with bone sculpting possible even after mobilization. Subdorsal septal height reduction always precedes completion of the osteotomy and nasal bone mobilization, to ensure patient safety with regard to skull base injury. Using the presented technical modifications, the risk of step deformities in the radix is minimized. In selected patients, dorsal preservation septorhinoplasty enables the surgeon to perform very conservative and precise deprojection of the nose with excellent outcomes, although the spectrum of possible complications is shifted in comparison to classic techniques. The preliminary experience of 205cases with arevision rate of less than 10% is promising. Afinal evaluation of the technique will only be possible after further studies and evaluation of long-term results.