title: Osteoectomy in Rhinoplasty: A New Concept in Nasal Bones Repositioning.
abstract: BACKGROUND
  Modern techniques of osteotomy have evolved to take into account the effects of bony repositioning on functional as well as aesthetic outcomes. Although a variety of methods have been described to appropriately mobilize and reposition the bony nasal vault, there is still no single procedure that can successfully manage nasal bones in its entirety.
  
  
  METHODS
  We present the bone chisel scraping osteoectomy technique for lateral and medial osteotomies with the aim of managing nasal bone deformities that can overcome diverse shortcomings of the conventional methods. The new operative method was performed in 184 nasal bone osteoectomies (92 patients, 22 men and 70 women), ranging in age from 18 to 69 years (mean age, 38 years). The functional results were evaluated postoperatively by the Nasal Obstruction Symptom Evaluation scale, a brief and easy to complete validated questionnaire with a final score grading from 0 to 100 at 3 and 6 months postoperatively.
  
  
  RESULTS
  With this new approach, no functional problems were reported. The mean Nasal Obstruction Symptom Evaluation scale score was 5.3 at 3 months and 1.9 at 6 months. Only 1 primary case was reoperated for open roof deformity. Comparing the results with the previous osteotomy series of the senior author osteoectomy and osteotomy revision rates for inadequate bone mobilization were similar but osteoectomy technique did not create functional problems as the osteotomy technique did.
  
  
  CONCLUSIONS
  Although this technique prolongs the operating time, it could offer considerable advantages in comparison with the classical techniques using osteotomies and hammer. This is because it offers a greater respect to the nasal respiratory function and gives a much better nasal base width control, resulting in more predictable results, less trauma, and therefore a lower risk of postoperative complications.
authors.affiliation: From the *Private Practice, Hakkı Yeten Caddesi, Istanbul, Turkey; †Private Practice, Via Isonzo, Rome, Italy; and ‡Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Bars
authors.initials: B
authors.lastname: Çakr
authors.forename: Valerio
authors.initials: V
authors.lastname: Finocchi
authors.forename: Damiano
authors.initials: D
authors.lastname: Tambasco
authors.forename: Ali Rza
authors.initials: AR
authors.lastname: Öreroğlu
authors.forename: Teoman
authors.initials: T
authors.lastname: Doğan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult