title: Quantifying the sharpness of osteotomes for dorsal hump reduction.
abstract: OBJECTIVE
  To assess the relative sharpness of osteotomes after multiple uses, routine maintenance, and sharpening.
  
  
  METHODS
  This prospective clinical study and mechanical model quantified the relative sharpness of identical osteotomes at baseline; after 3, 6, and 9 uses; and after sharpening techniques compared with osteotomes from hospital central supply. The Instron universal tester developed a force-displacement curve as the osteotome blade cut a standardized suture. Force required to cut the suture is inversely proportional to osteotome sharpness.
  
  
  RESULTS
  For osteotomes 1, 2, and 3, dullness occurred after 9 uses (4.836 lb; P < .001), 6 uses (4.431 lb; P < .005), and 3 uses (4.093 lb; P < .02), respectively. Osteotome 1 was professionally sharpened after 9 uses and retested (3.156 lb); results were similar to those for an osteotome used 6 times (3.160 lb). Additional sharpening showed significantly poorer performance (7.737 lb; P < .001 at baseline and after 9 uses). Osteotome 3 was hand sharpened after 6 uses and retested (7.750 lb; baseline P < .001). Two osteotomes from central supply required almost twice the cutting force relative to the senior author's osteotomes.
  
  
  CONCLUSIONS
  Although osteotome performance decreased significantly over time, professional sharpening only achieved results similar to an osteotome used 3 to 6 times. Further resharpening seems detrimental to performance. Surgeons may want to consider osteotomes disposable instruments.
authors.affiliation: Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Bloom
authors.forename: Evan R
authors.initials: ER
authors.lastname: Ransom
authors.forename: Marcelo B
authors.initials: MB
authors.lastname: Antunes
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Becker
mesh_terms: D006801:Humans; D010027:Osteotomy / Q000295:instrumentation*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000295:instrumentation* / Q000379:methods