One-Piece Nasal Osteotomy for the Correction of a Centrally Deviated Nose

A severely crooked nose due to trauma or other causes is difficult to correct. Although various nasal osteotomy techniques have been suggested, satisfactory outcomes have not always been achieved especially in centrally deviated noses. Definite correction of the midline and shape of the bony framework is necessary. We aimed to investigate a novel one-piece nasal bone osteotomy approach consisting of transverse osteotomy continued with bilateral lateral osteotomies for the correction of a centrally deviated nose.

This retrospective chart review included 66 consecutive patients who underwent corrective rhinoplasty with nasal bone osteotomy for a deviated nose. Group 1 was treated with one-piece osteotomy, and group 2 was treated with conventional lateral and/or medial osteotomy. Available preoperative and postoperative three-dimensional facial bone computed tomography images were used to quantify nasal landmarks through three-dimensional reconstruction. Patient satisfaction was evaluated using a rhinoplasty outcome evaluation questionnaire.

Measurements of nasal landmark angles toward the longitudinal facial midline plane showed a statistically narrowed postoperative angle in group 1 (subnasale landmark: preoperative angle 1.66 ± 0.29° [group 1] vs. 0.76 ± 1.09° [group 2]; postoperative angle 0.96 ± 0.77° [group 1] vs. 0.31 ± 0.29° [group 2]). The questionnaire scores revealed higher satisfaction (3.11 ± 2.38 vs. 1.157 ± 1.147) and a higher proportion of 4-point scores in group 1.

This is the first study to introduce the one-piece nasal osteotomy technique for centrally deviated noses. The technique consists of transverse osteotomy with bilateral osteotomies in one stage, thus the name "one-piece." Considering anatomic variances in Asian rhinoplasty, a deviated nose should be effectively corrected to obtain satisfactory outcomes. We demonstrated the efficacy and satisfactory outcomes of this new technique.

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