Skip to main content
Erschienen in: Aesthetic Plastic Surgery 1/2017

28.12.2016 | Original Article

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

verfasst von: Yalcin Yontar, Sedat Tatar

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

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.

Methods

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 12 months after the operation.

Results

The technique presented here was performed on 19 male and 38 female patients with a mean age of 24.95 ± 6.07 years. The mean height of the nasal hump was 4.65 ± 1.56 mm. No patient had complications requiring further corrective surgery. The “Rhinoplasty Outcome Evaluation” questionnaire showed that all patients remained in the group of happy subjects.

Conclusions

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.

Level of Evidence V

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.
Literatur
1.
Zurück zum Zitat Jin HR, Won TB (2007) Nasal hump removal in Asians. Acta Oto Laryngol Suppl 558:95–101CrossRef Jin HR, Won TB (2007) Nasal hump removal in Asians. Acta Oto Laryngol Suppl 558:95–101CrossRef
2.
Zurück zum Zitat Lee MR, Unger JG, Rohrich RJ (2011) Management of the nasal dorsum in rhinoplasty: a systematic review of the literature regarding technique, outcomes, and complications. Plast Reconstr Surg 128:538e–550eCrossRefPubMed Lee MR, Unger JG, Rohrich RJ (2011) Management of the nasal dorsum in rhinoplasty: a systematic review of the literature regarding technique, outcomes, and complications. Plast Reconstr Surg 128:538e–550eCrossRefPubMed
3.
Zurück zum Zitat Holt GR, Garner ET, McLarey D (1987) Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am 20:853–876PubMed Holt GR, Garner ET, McLarey D (1987) Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am 20:853–876PubMed
4.
Zurück zum Zitat Rohrich RJ, Muzaffar AR, Janis JE (2004) Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty. Plast Reconstr Surg 114:1298–1308CrossRefPubMed Rohrich RJ, Muzaffar AR, Janis JE (2004) Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty. Plast Reconstr Surg 114:1298–1308CrossRefPubMed
5.
Zurück zum Zitat Halewyck S, Michel O, Daele J, Gordts F (2010) A review of nasal dorsal hump reduction techniques, with a particular emphasis on a comparison of component and composite removal. B-ENT Suppl 15:41–48 Halewyck S, Michel O, Daele J, Gordts F (2010) A review of nasal dorsal hump reduction techniques, with a particular emphasis on a comparison of component and composite removal. B-ENT Suppl 15:41–48
6.
Zurück zum Zitat Esenlik E, Kaya B, Gülsen A, Çukurluoğlu O, Özmen S, Yavuzer R (2011) Evaluation of the nose profile after maxillary advancement with impaction surgeries. J Craniofac Surg 22:2072–2079CrossRefPubMed Esenlik E, Kaya B, Gülsen A, Çukurluoğlu O, Özmen S, Yavuzer R (2011) Evaluation of the nose profile after maxillary advancement with impaction surgeries. J Craniofac Surg 22:2072–2079CrossRefPubMed
7.
Zurück zum Zitat Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthet Plast Surg 24:192–197CrossRef Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthet Plast Surg 24:192–197CrossRef
8.
Zurück zum Zitat Izu SC, Kosugi EM, Brandão KV, Lopes AS, Garcia LBS, Suguri VM, Gregório LC (2012) Normal values for the Rhinoplasty Outcome Evaluation (ROE) questionnaire. Braz J Otorhinolaryngol 78:76–79CrossRefPubMed Izu SC, Kosugi EM, Brandão KV, Lopes AS, Garcia LBS, Suguri VM, Gregório LC (2012) Normal values for the Rhinoplasty Outcome Evaluation (ROE) questionnaire. Braz J Otorhinolaryngol 78:76–79CrossRefPubMed
9.
Zurück zum Zitat Vermeiren J, De Vos G (2006) The feather touch rasp, a powered instrument for hump reduction. B-ENT 3:113–117 Vermeiren J, De Vos G (2006) The feather touch rasp, a powered instrument for hump reduction. B-ENT 3:113–117
10.
Zurück zum Zitat Davis RE, Raval J (2003) Powered instrumentation for nasal bone reduction: advantages and indications. Arch Facial Plast Surg 5:384–391CrossRefPubMed Davis RE, Raval J (2003) Powered instrumentation for nasal bone reduction: advantages and indications. Arch Facial Plast Surg 5:384–391CrossRefPubMed
11.
Zurück zum Zitat Pribitkin EA, Lavasani LS, Shindle C, Greywoode JD (2010) Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator. Laryngoscope 120:1504–1507CrossRefPubMed Pribitkin EA, Lavasani LS, Shindle C, Greywoode JD (2010) Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator. Laryngoscope 120:1504–1507CrossRefPubMed
12.
Zurück zum Zitat Avşar Y (2009) Nasal hump reduction with powered micro saw osteotomy. Aesthet Surg J 29:6–11CrossRefPubMed Avşar Y (2009) Nasal hump reduction with powered micro saw osteotomy. Aesthet Surg J 29:6–11CrossRefPubMed
13.
Zurück zum Zitat Becker DG (2002) The powered rasp: advanced instrumentation for rhinoplasty. Arch Facial Plast Surg 4:267–268CrossRefPubMed Becker DG (2002) The powered rasp: advanced instrumentation for rhinoplasty. Arch Facial Plast Surg 4:267–268CrossRefPubMed
14.
15.
Zurück zum Zitat Goumain J (1974) Cutting forceps for lateral osteotomy in rhinoplasty. Plast Reconstr Surg 53:358–359CrossRefPubMed Goumain J (1974) Cutting forceps for lateral osteotomy in rhinoplasty. Plast Reconstr Surg 53:358–359CrossRefPubMed
17.
Zurück zum Zitat Neuner O (1971) A simple procedure for correction of the hump nose. Br J Plast Surg 24:375–381CrossRefPubMed Neuner O (1971) A simple procedure for correction of the hump nose. Br J Plast Surg 24:375–381CrossRefPubMed
18.
Zurück zum Zitat Kazanjian VH, Holmes EN (1947) New rongeur for removing a nasal hump. Arch Otolaryngol 45:361–364CrossRefPubMed Kazanjian VH, Holmes EN (1947) New rongeur for removing a nasal hump. Arch Otolaryngol 45:361–364CrossRefPubMed
19.
Zurück zum Zitat Rowland AL (1955) A new cross-action nasal hump rongeur. Plast Reconstr Surg 15:509–511CrossRef Rowland AL (1955) A new cross-action nasal hump rongeur. Plast Reconstr Surg 15:509–511CrossRef
20.
Zurück zum Zitat Barton RT (1952) Use of the Kazanjian rongeur in rhinoplastic surgery. AMA Arch Otolaryngol 55:478–483CrossRefPubMed Barton RT (1952) Use of the Kazanjian rongeur in rhinoplastic surgery. AMA Arch Otolaryngol 55:478–483CrossRefPubMed
21.
Zurück zum Zitat Daniel RK (2010) Mastering rhinoplasty: a comprehensive atlas of surgical techniques with integrated video clips. Springer, BerlinCrossRef Daniel RK (2010) Mastering rhinoplasty: a comprehensive atlas of surgical techniques with integrated video clips. Springer, BerlinCrossRef
22.
Zurück zum Zitat Pearlman SJ, Talei BA (2012) An anatomic basis for revision rhinoplasty. Facial Plast Surg 28:390–397CrossRefPubMed Pearlman SJ, Talei BA (2012) An anatomic basis for revision rhinoplasty. Facial Plast Surg 28:390–397CrossRefPubMed
Metadaten
Titel
A Practical Technique for Reduction of the Bony Nasal Dorsum Height Using Kazanjian Bone-Cutting Forceps
verfasst von
Yalcin Yontar
Sedat Tatar
Publikationsdatum
28.12.2016
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2017
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-016-0737-3

Weitere Artikel der Ausgabe 1/2017

Aesthetic Plastic Surgery 1/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.