External vs. internal osteotomy in rhinoplasty

Indian J Otolaryngol Head Neck Surg. 2007 Mar;59(1):9-12. doi: 10.1007/s12070-007-0002-9. Epub 2007 Apr 26.

Abstract

Background: The aim of study is to compare the external osteotomy vs. internal osteotomy in patients undergoing rhinoplasty.

Methods: The study group comprised of 45 patients that had undergone rhinoplasty surgery. The 25 patients had undergone internal / endonasal continuous lateral osteotomy and 20 patients had undergone external / percutaneous perforating digital osteotomy. The internal osteotomy was done high to low to high using 4 mm. curved guarded osteotome. The external osteotomy was done by 2 mm sharp osteotome. The scoring system of Kara and Gokalan was followed for edema and ecchymosis.

Conclusion: External osteotomy is an easy approach to carryout and makes fracture with high precision along preset lines. The bone stump is stable. The damage to the nasal mucosa is much less. There is reduced bleeding, reduced edema and reduced ecchymosis around eyes. The cutaneous scar at the entry site of osteotome is invisible.

Keywords: Lateral osteotomy; internal / endonasal osteotomy; percutaneous perforating digital osteotomy.