The Impact of an Additional Osteotomy Maneuver for Nasal Bone Convexity on Let-Down Rhinoplasty

Öz

Objective: To evaluate the effect of an additional piezo-assisted transverse osteotomy on C-shaped nasal deformities in let-down rhinoplasty. Material and Methods: A retrospective review was conducted on 24 patients who underwent closed preservation rhinoplasty with an additional transverse osteotomy using piezoelectric instrumentation between 2021 and 2023. Preoperative and postoperative aesthetic and functional outcomes were assessed using the Rhinoplasty Outcome Evaluation (ROE) and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires. Statistical analysis included correlation and multiple linear regression to identify predictors of outcome. Results: Postoperative ROE scores showed a significant increase from 4.3±2.7 to 18.6±3.4 (p<0.001), indicating a marked enhancement in aesthetic satisfaction following the procedure. Likewise, NOSE scores decreased significantly from 14.8±2.7 to 5.5±2.2 (p<0.001), reflecting substantial improvement in nasal breathing function. Notably, age was found to be the only significant predictor of functional improvement, with older patients experiencing less favorable outcomes. A significant inverse correlation was observed between age and the change in NOSE scores (r=-0.480, p=0.018). Other demographic and operative variables—including gender, follow-up duration, and operative time—did not show any statistically significant relationship with changes in either ROE or NOSE scores. These findings highlight the value of individualized surgical planning, particularly in younger patients, to maximize both functional and aesthetic outcomes. Conclusion: The addition of a piezo-assisted transverse osteotomy in the surgical treatment of C-shaped nasal deformities appears to significantly improve both aesthetic and functional outcomes. This maneuver offers precise correction of lateral convexities with minimal tissue trauma, supporting its role as a valuable adjunct in preservation rhinoplasty techniques.

Anahtar Kelimeler

• Crooked nose
• preservation rhinoplasty
• piezoelectric osteotomy
• transverse osteotomy
• nasal bone convexity
• functional outcome
• aesthetic outcome

Let-Down Rinoplastide Nazal Kemik Konveksitesi İçin Ek Osteotomi Manevrasının Etkisi

Öz

Amaç: Bu çalışmada, let-down rinoplasti uygulanan C şeklindeki nazal deformiteli hastalarda ek piezo yardımlı osteotomi manevrasının estetik ve fonksiyonel sonuçlar üzerindeki etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: 2021–2023 yılları arasında C şeklinde nazal deviasyon ve lateral nazal kemik konveksitesi nedeniyle kapalı koruyucu let-down rinoplasti uygulanan 24 hasta retrospektif olarak değerlendirildi. Tüm hastalarda ek piezo yardımlı osteotomi manevrası uygulandı. Estetik ve fonksiyonel sonuçlar, ameliyat öncesi ve sonrası Rhinoplasty Outcome Evaluation (ROE) ve Nasal Obstruction Symptom Evaluation (NOSE) ölçekleri kullanılarak değerlendirildi. Klinik sonuçları etkileyen olası faktörleri belirlemek amacıyla korelasyon ve çoklu doğrusal regresyon analizleri yapıldı. Bulgular: Ameliyat sonrası ROE skorları ameliyat öncesine göre anlamlı şekilde arttı ve 4,3±2,7’den 18,6±3,4’e yükseldi (p<0,001). Bu bulgu, estetik memnuniyette belirgin bir iyileşme olduğunu göstermektedir. Benzer şekilde NOSE skorları ameliyat öncesi 14,8±2,7 iken ameliyat sonrası 5,5±2,2’ye düştü (p<0,001), bu da nazal solunum fonksiyonunda anlamlı iyileşme olduğunu göstermektedir. Yaş, fonksiyonel iyileşmenin tek anlamlı belirleyicisi olarak saptandı; yaş arttıkça NOSE skorundaki iyileşmenin azaldığı görüldü (r=-0,480, p=0,018). Cinsiyet, takip süresi ve operasyon süresi ile ROE veya NOSE skorlarındaki değişim arasında istatistiksel olarak anlamlı ilişki saptanmadı. Sonuç: C şeklindeki nazal deformitelerin cerrahi tedavisinde let-down rinoplastiye eklenen piezo yardımlı osteotomi manevrası, hem estetik hem de fonksiyonel sonuçlarda anlamlı iyileşme sağlamaktadır. Bu teknik, lateral nazal kemik konveksitelerinin daha hassas ve kontrollü şekilde düzeltilmesine olanak tanıyarak koruyucu rinoplasti yaklaşımlarında değerli bir yardımcı manevra olarak değerlendirilebilir.

Anahtar Kelimeler

• Eğri burun
• Koruyucu rinoplasti
• Piezoelektrik osteotomi
• Transvers osteotomi
• Nazal kemik konveksitesi
• Fonksiyonel sonuç
• Estetik sonuç

Kaynakça

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