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Endonasal Endoscopic Approach for Bone Spicule Removal: A Case Report.

Utku Kubilay1, Kaan Işıklar2

  • 1Department of Otolaryngology-Head and Neck Surgery, Health Sciences University İzmir Tepecik Training and Research Hospital, İzmir, Turkey.

Case Reports in Otolaryngology
|February 6, 2026
PubMed
Summary

Bone spicules (BSs) after rhinoplasty can cause cosmetic issues. Endonasal endoscopic approach (EEA) offers a minimally invasive solution for removing overlooked BSs, ensuring successful patient outcomes.

Keywords:
endoscopyminimally invasive surgical proceduresosteotomypostoperative complicationsrhinoplasty

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Surgical Complications

Background:

  • Bone spicules (BSs) can form during rhinoplasty, especially with blunt instruments.
  • Undetected BSs may lead to postoperative cosmetic deformities and nasal swelling.

Purpose of the Study:

  • To highlight the complications associated with bone spicules in rhinoplasty.
  • To present endonasal endoscopic approach (EEA) as an effective treatment for bone spicule removal.

Main Methods:

  • A case report of a patient with a bone spicule causing cosmetic issues post-rhinoplasty.
  • Utilized paranasal sinus computerized tomography for BS detection.
  • Performed endonasal endoscopic approach (EEA) for BS extraction.

Main Results:

  • Successful removal of the bone spicule via EEA.
  • Patient experienced no complaints at 13-month follow-up.
  • EEA proved to be a minimally invasive, practical, and successful extraction method.

Conclusions:

  • Preventing BS formation requires precise osteotomies using sharp instruments.
  • Intraoperative detection and removal of BSs are crucial.
  • EEA is a valuable, scarless technique for managing overlooked bone spicules.