Comparison of internal and external lateral osteotomy in rhinoplasty.

Abstract

Background: Rhinoplasty stands as one of the most prevalent cosmetic procedures worldwide and exhibits a rising trend. A variety of techniques have been developed to mitigate complications such as bleeding, periorbital edema, bruising, excessive nasal mucosa damage, and asymmetry, all of which can result in aesthetic deformity and nasal obstruction. These techniques encompass both external osteotomy and internal osteotomy, with the choice between them resting upon the preferences and practices of the surgeon. Consequently, the present study endeavors to compare these two methods in terms of outcomes and complications.

Aim: The primary objective of this research is to assess the outcomes and complications of rhinoplasty by juxtaposing internal and external nasal bone osteotomy.

Materials and Methods: Following informed consent, patients were prepared for surgery and allocated randomly into two groups: the first group which underwent rhinoplasty surgery via external osteotomy, and the second group which underwent rhinoplasty surgery via internal osteotomy. External osteotomy involved the use of a 2 mm straight osteotomy technique, creating a stab incision in the skin with an 11-gauge surgical scalpel and subsequently maneuvering the osteotomy head along the osteotomy path, punctuating this path at intervals. Internal osteotomy, on the other hand, utilized a 4 mm osteotomy by positioning the osteotomy above the pyriform fossa beyond the inferior iris level and guiding it along the nasolabial notch pathway palpably beneath the skin. Surgical results and postoperative complications, encompassing bruising, edema, and bone slippage, were diligently documented at the time of Habib. The findings were then meticulously recorded and inputted into the statistical software SPSS Version 26 for subsequent analysis.

Results: The study's sample comprised 60 patients ranging in age from 18-50 years (26.8 ± 7.5 years). Among these patients, a mere 6 individuals (10%) were male, while the remaining 54 (90%) were female. In the first group, there were 2 male patients (6.7%) and 28 female patients (93.3%). The average post-surgery pain score was determined to be 4.3 ± 0.9. Mucosal damage was discernible in only 3 patients from the first group (5%) and 5 patients from the second group (8%). Notably, no statistically significant variance was observed between the two groups concerning grades 2 and 4; however, distinctions were evident in grades 1 and 3, particularly in relation to edema occurrence. Grade 2 displayed a marked contrast in patient distribution concerning bone slippage severity and a comparison between the two groups, illustrating a notable advantage for the second group in terms of outcomes over the first group.

Conclusions: Both internal and external osteotomy methodologies exhibit inherent advantages and drawbacks, with internal osteotomy notably curtailing soft tissue trauma, asymmetry, slippage, contusions, and edema when executed by a proficient specialist.