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Lateral nasal osteotomy is a critical step in rhinoplasty and is usually performed to close an open roof following dorsal reduction (1). Different types of instruments and surgical techniques have been described by many authors. The basic points of argument in the literature include the ideal instrument for performing the osteotomy, the site and type of incision, the creation of periosteal tunnel and the direction of osteotomy (1-11). Goldfarb et al (2) described some complications of rhinoplasty, several of which were the direct result of lateral osteotomy. These complications included mucoid cysts along the lines of the osteotomy, lacrimal sac injury and hemorrhage secondary to the trauma caused by the osteotome. Furthermore, morbidity in the form of edema and ecchymosis was more pronounced in rhinoplasty patients who had a lateral osteotomy. In this paper, a prospective, controlled study investigated whether the creation of a periosteal tunnel before performing lateral nasal osteotomies influences the degree of postoperative ecchymosis.

Lateral nasal osteotomies: Does the creation of a periosteal tunnel influence the degree of postoperative ecchymosis?