Medial nasal bone trimming for managing the deviated and or wide bony vault in Asians

Medial nasal bone trimming for managing the deviated and or wide bony vault in Asians

Background: Managing the bony vault in rhinoplasty is challenging despite the use of various techniques. High revision rates persist due to recurrent or residual deviations. In severe cases, intermediate osteotomy is difficult in Korean patients due to their shorter and thicker nasal bones. Objective: Managing the bony vault is challenging in rhinoplasty procedures. This study aimed to evaluate the results of medial nasal bone trimming to correct deviated and wide bony vaults. Methods: This retrospective study included patients who underwent rhinoplasty with medial nasal bone trimming at a single hospital between June 2010 and June 2013. Medical records including diagnoses, computerized preoperative tomography scans, operation records, intraoperative photographs, postoperative results, and complications were collected. Postoperative aesthetic improvement was evaluated using a 4 point-Likert scale. Results: Fifty patients were included, of which 31 patients were diagnosed with a deviated nasal dorsum, 12 with a deviated nasal dorsum, and seven with a wide nasal dorsum without deviation. Nasal bone trimming was performed bilaterally and unilaterally in 29 and 21 patients, respectively. Postoperative aesthetic score was 2.31±0.61, 2.57±0.45, and 2.7±0.56 for the patients in the deviated, deviated and wide, and wide without deviated groups, respectively. Conclusion: Medial nasal bone trimming can be a simple, safe, and effective procedure for achieving symmetry and narrowing of the bony vault in patients with a deviated or wide bony pyramid.