SELF: A Novel Algorithm for Deciding the Position of Lateral Osteotomies in Rhinoplasty Patients with Minimal...

Area of Science:

• Plastic Surgery
• Rhinologic Surgery
• Nasal Anatomy

Background:

• Traditional methods for determining lateral osteotomy position rely on frontal view and palpation.
• Literature on precise lateral osteotomy placement, especially for minimally deviated noses, is limited.
• Existing techniques for lateral osteotomies are well-established but lack specific guidance for side selection.

Purpose of the Study:

• To introduce and evaluate the SELF algorithm for guiding lateral osteotomy decisions in rhinoplasty.
• To assess the efficacy and safety of the SELF algorithm in determining the position and number of lateral osteotomies.
• To provide surgeons with a structured approach for lateral osteotomy placement, particularly in challenging cases.

Main Methods:

• The SELF algorithm, incorporating four developmental parameters (septal position, external alar length, lateral pyramidal length, frontal pyramidal deviation), was utilized.
• The algorithm guided the decision for either double lateral or high lateral osteotomy based on the longer bony wall.
• Surgical decisions were made by evaluating these four parameters for each patient.

Main Results:

• The SELF algorithm was applied to 521 patients (493 female, 28 male) aged 18-59.
• 401 double lateral osteotomies and 85 high lateral osteotomies were performed based on the algorithm's assessment.
• No significant functional or aesthetic complications related to the lateral osteotomies were reported.

Conclusions:

• A correlation exists between nasal septum position, alar length, pyramidal projection, and frontal deviation due to developmental influences.
• The SELF algorithm offers a valuable tool for surgeons to select the optimal position and number of lateral osteotomies.
• This algorithm is particularly beneficial for improving outcomes in rhinoplasty cases with minimally deviated noses.