title: The use of Heanley bone-cutting forceps to reduce the thickened and broad bony dorsum in rhinoplasty.
abstract: Heanley bone-cutting forceps can be used in a modified rhinoplasty technique for patients with nasal bones that are broad and thickened by callus as a result of several previous nasal fractures. In these patients, the conventional technique of dehumping followed by medial and lateral osteotomies may leave a roof of thickened nasal bones due to callus formation that prevents the pyramid from being narrowed. In this situation, Heanley forceps may be used instead of medial osteotomies to resect paramedian segments of the remaining thickness of the nasal bones so that the nasal bones can be medialized. If no dehumping is required and the bones are just splayed and thickened by callus, Heanley forceps can be used before infracturing and lateral osteotomies. Several points are important for the success of this technique, including introducing the beaks of the forceps submucosally in the correct plane on each side of the nasal bones, advancing the tips of the forceps as far as the nasion, and mobilizing the bony segments before performing lateral osteotomies.
authors.affiliation: Department of Otorhinolaryngology, University Hospital, Nottingham NG7 2UH, England. nick.jones@nottingham.ac.uk
authors.forename: Kunwar
authors.initials: K
authors.lastname: Bhatia
authors.forename: Nick S
authors.initials: NS
authors.lastname: Jones
authors.forename: Tony R
authors.initials: TR
authors.lastname: Bull
mesh_terms: D002146:Bony Callus / Q000601:surgery*; D006801:Humans; D009295:Nasal Bone / Q000601:surgery*; D012225:Rhinoplasty / Q000295:instrumentation*; D013525:Surgical Instruments