Abstract

OBJECTIVE: In this study, we aimed to compare the use of an osteotome versus concave saw blade during septorhinoplasty in terms of bony pyramid complications.

METHODS: Between July 2017 and November 2018, of a total of 270 patients who underwent septorhinoplasty using closed technique in our clinic, 23 were excluded due to missing follow-up visits. The remaining 247 patients (88 males, 159 females; mean age 26.8 years; range, 18 to 54 years) were retrospectively divided into two groups. In the first group (classical group, n=104), median osteotomies were performed through an internal route, while lateral osteotomies were done from the lateral (submucous) lower turbinate using osteotomes. In the second group (saw blade group, n=143), median osteotomies were performed using a standard internal rhinoplasty saw blade and lateral osteotomies were done through the submucous route using a concave rhinoplasty saw blade. At 12 months postoperatively, an examination for stair step, deviated nose, and saddle nose deformities was carried out by a second specialist who was blinded to the operation technique and the examination findings were evaluated.

RESULTS: Thirteen patients in the classical group and three patients in the saw blade group had stair step deformity. There was a statistically significant difference in the frequency of stair step deformity between the groups (p=0.001). None of the patients had saddle nose deformity. Deviated nasal deformities were observed in seven patients in the classical group and three patients in the saw group. No statistically significant correlation was found in terms of the incidence of deviated nasal deformity (p=0.090).

CONCLUSION: The use of a concave saw blade for lateral osteotomy during septorhinoplasty may be an effective method which reduces the occurrence of stair step deformity, preserving the bone stabilization.