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Related Experiment Video

Updated: Mar 23, 2026

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Intranasal Extramucosal Access: A New Access for Lateral Osteotomy in Open Rhinoplasty.

Ali Teoman Tellioglu1, Elif Sari, Hulda Rifat Ozakpinar

  • 1*Department of Plastic, Reconstructive and Aesthetic Surgery, Diskapi Yildirim Beyazit Training and Research Hospital†Department of Plastic, Reconstructive and Aesthetic Surgery, Yildirim Beyazit University Medical School, Ankara‡Department of Plastic, Reconstructive and Aesthetic Surgery, Kirikkale University Faculty of Medicine, Kirikkale§Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey.

The Journal of Craniofacial Surgery
|March 22, 2016
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Summary

A novel intranasal extramucosal approach for lateral osteotomy in open rhinoplasty offers improved exposure and predictable results. This technique minimizes scarring and protects the nasal periosteum, overcoming drawbacks of traditional methods.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Facial Plastic Surgery

Background:

  • Traditional lateral osteotomy techniques in rhinoplasty present several disadvantages.
  • A new intranasal extramucosal access (open sky access) was developed to address these limitations.

Purpose of the Study:

  • To introduce and evaluate a novel intranasal extramucosal access for performing lateral osteotomies during open rhinoplasty.
  • To demonstrate the advantages of this technique over existing methods.

Main Methods:

  • Anatomical study on cadavers to assess the feasibility of intranasal extramucosal access for lateral osteotomy.
  • Clinical application in 23 consecutive open rhinoplasty patients (19 primary, 4 secondary) with a mean follow-up of 17 months.

Main Results:

  • The intranasal extramucosal approach was successfully performed in all patients.
  • No intraoperative hemorrhage, minimal edema and ecchymosis, and no nasal mucosal tearing were observed.
  • Absence of residual bone spurs or irregularities was noted post-procedure.

Conclusions:

  • Intranasal extramucosal access provides precise, predictable, and reproducible aesthetic and functional outcomes in lateral osteotomy.
  • This technique offers superior exposure, minimizes scarring by avoiding external incisions, and protects the internal periosteum.