Open AccessQuantifying Osteotome Sharpness: Comparing the Major Manufacturers
Author(s) -
Ransom Evan R.,
Becker Daniel,
Bloom Jason D.,
Antunes Marcelo B.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811416318a29
Subject(s) - osteotome , orthodontics , rhinoplasty , osteotomy , dentistry , biomedical engineering , medicine , surgery , nose
Objective 1) Develop a method for quantification of osteotome sharpness in a rhinoplasty model, using artificial bone; 2) demonstrate changes in osteotome sharpness over multiple uses; and, 3) compare sharpness of osteotomes from different manufacturers at baseline and after multiple uses. Method Osteotomes were passed through synthetic bone blocks. Sharpness was measured using the Instron Universal Tester (force required to cut #2 Prolene suture) at baseline and after 1, 4, 7, and 10 osteotomies. Changes in sharpness over time were assessed using within‐sample t tests. Comparison of manufacturers was performed with multiway ANOVA. Results A novel, prospective surgical model was developed. Osteotomes from 5 manufacturers were tested (Nextedge, Black & Black, Storz, Miltex, and Biomet). Baseline measurements showed that the Storz osteotome was sharpest (1.74 lbs, P <. 001), followed by Miltex and Biomet (2.50 lbs, 2.68 lbs), and Nextedge and Black & Black (3.48 lbs, 3.40 lbs). All osteotomes except Nextedge ( P =. 098) demonstrated a significant decrease in sharpness over time ( P =. 02 to P <. 001), though relative changes and absolute sharpness varied widely between instruments. ANOVA showed the Storz osteotome was significantly sharper across all uses and timepoints ( P <. 001). The greatest decrease in sharpness over time was seen with Black & Black (‐1.28 lbs). Conclusion Otolaryngologists use osteotomes in cosmetic and functional rhinoplasty. Millimeter‐level accuracy in these procedures is essential to maximize outcome and minimize complications. Multiple similar‐appearing instruments are available, but their relative efficacy is infrequently tested. We have demonstrated that, at least in the case of osteotomes, not all instruments are created equally.