<< Back to the abstract archive
Novel Application of the Piezoelectric Device with an Intraoral Approach to Lateral Osteotomies in Rhinoplasty, An Anatomical Study
Anthony DeLeonibus MD, Marco Swanson MD, Viren Patel MD, Vikas Kotha MD, Bahar Bassiri Gharb MD PhD, Antonio Rampazzo MD PhD
Cleveland Clinic Foundation
2023-02-10
Presenter: Anthony DeLeonibus, MD
Affidavit:
Certify that this work is the author's own and that it has not been published or presented before.
Director Name: Steven Bernard, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction
Lateral osteotomies (LO) are the mainstay modality to close reduced prominent dorsal humps or address widened nasal bones in patients undergoing rhinoplasty. Despite their accepted role in rhinoplasty, there is variation in how surgeons osteotomize the nasal bones, with classic reports describing an intranasal or percutaneous approach. Here, we present the first report of using the piezoelectric device to perform LOs through an intraoral approach in a series of cadavers.
Materials and Methods
Open rhinoplasty was performed followed by a 2cm intraoral dissection of the bilateral medial maxillary buttresses intraorally exposing the nasofacial junction. Low to low lateral osteotomies was performed with piezoelectric surgery in all cadavers. The duration of exposure, dissection and osteotomy was recorded along with dimensions of dissection. Video nasal endoscopy was subsequently performed to evaluate for intranasal mucosal injury.
Results
All cadavers were Caucasian (5 females and 2 males). Median time to open the nose was 13.77 (IQR 5.05 minutes). The median piezo osteotomy time took 1.70 (IQR 0.53 minutes) and 1.73 (IQR 1.06 minutes) for the right and left side, respectively. Out of the 7 cadavers, (14 total dissections), all sides demonstrated no mucosal lacerations.The external branch of anterior ethmoidal nerve and infraorbital nerve were always preserved.
Conclusion
Direct visualization of the dissection and osteotomy allows for a consistent and precise approach at narrowing the nasal bones. This study demonstrates that piezoelectric intraoral lateral osteotomies is a safe, expeditious and reproducible means to narrow the bony vault without the need for extensive nasal dissection.
