Straightening Crooked Nose with Precise Bone Refining

Objectives: Crooked noses pose significant challenges in rhinoplasty due to their complex anatomy, particularly in the bony vault. Traditional methods focus on osteotomies but often do not equalize the lengths of the nasal bones. This study introduces a novel technique using otologic drills to address this problem by shortening the longer nasal bone and aligning the nasion-rhinion line at the midline. Methods: A Goodman incision was made to access the nasal bones under general anesthesia. Otologic drills were used for lateral and transverse ostectomies to shorten the longer nasal bone and reposition the nasal bone vault. Follow-ups were conducted 3, 6, and 12 months after surgery. Results: Of 48 cases (22 men and 26 women), 47 achieved satisfactory results with a straightened nose. One case showed a slight deviation after surgery, which did not require revision. Discussion: The technique effectively addresses the issue of asymmetric nasal bone lengths, which traditional methods often overlook. Using otologic drills allows precise bone cutting, contributing to long-lasting outcomes. Conclusions: Otologic drill-assisted ostectomies effectively equalize nasal bone lengths, improving nasal symmetry. More research with larger case series and long-term follow-up is needed to confirm the efficacy and safety of this technique, including potential applications in closed rhinoplasty.