Osteotomy techniques to correct posttraumatic deviation of the nasal pyramid: a technical note.

BACKGROUND AND OBJECTIVES Correction of the deviated nasal pyramid is frequently incomplete and may result in a sub-optimal surgical outcome. Precise anatomic analysis of the deformity and a thorough understanding of available techniques improve the surgical osteotomy. METHODS AND MATERIALS The advantages and disadvantages of the various osteotomy techniques are analyzed, based on the cadaver studies and clinical experience of the authors. The cadaver studies demonstrate the anatomic results when various osteotomes are used in specified ways. Clinical outcomes in the treatment of posttraumatic nose deviations correlate well with these results. RESULTS AND/OR CONCLUSIONS A thorough understanding of the advantages and disadvantages of various osteotomy techniques enables the surgeon to apply them to specific anatomical deformities in posttraumatic nose deviations more precisely. In general, perforating osteotomies preserve more soft tissue support than the linear osteotomies. Sequential osteotomies, occasionally combined with intermediate osteotomies, are useful in straightening the extremely deviated nasal pyramid.