title: Sonic rhinoplasty: sculpting the nasal dorsum with the ultrasonic bone aspirator.
abstract: OBJECTIVE
  Rhinoplasty often requires precise, graded bone removal without damage to surrounding nasal soft tissue and mucosa. Unfortunately, current techniques are associated with decreased visualization, heat generation, mechanical chatter, and lack of surgical precision with resultant soft tissue injury. We introduce a novel technique to sculpt the nasal dorsum in a precise fashion with the ultrasonic bone aspirator and delineate its advantages over conventional techniques.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  The SONOPET ultrasonic bone aspirator (Mutoh Co., Ltd., Tokyo, Japan) utilizes ultrasonic waves to emulsify bone with concurrent irrigation and suction, enabling precise, graded bone removal under direct visualization without thermal or mechanical injury to the surrounding soft tissue or mucosa. We describe the application of this technology to dorsal hump reduction with early follow-up to 9 months. Successful reduction was determined by the senior author at postoperative follow-up appointments.
  
  
  RESULTS
  Sixty patients underwent open rhinoplasty requiring dorsal reduction with the ultrasonic bone aspirator. No individuals experienced delayed healing, infection, scarring, or major complications. Five of 60 patients had minor post surgical irregularities, which included visible nasal dorsum deformity, palpable nasal deformity, under-resection of the dorsum, and asymmetry of the nasal dorsum. No postoperative open sky deformities, inverted "V" deformities, over-resected dorsums, or skin injuries were observed.
  
  
  CONCLUSIONS
  Ultrasonic bone aspiration permits safe, precise, graded bone removal without damaging surrounding nasal soft tissue and mucosa. We introduce novel applications of the ultrasonic bone aspirator in dorsal reduction that provide significant advantages over conventional techniques.
authors.affiliation: Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. edmund.pribitkin@jefferson.edu
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Pribitkin
authors.forename: Leela S
authors.initials: LS
authors.lastname: Lavasani
authors.forename: Carol
authors.initials: C
authors.lastname: Shindle
authors.forename: Jewel D
authors.initials: JD
authors.lastname: Greywoode
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009666:Nose / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000295:instrumentation*; D014464:Ultrasonic Therapy