RHINOPLASTY WITH NASAL BONE DISARTICULATION TO DEEPEN THE NASOFRONTALGROOVE - EXPERIMENTAL AND CLINICAL-RESULTS

Deepening of the nasofrontal groove is considered a fiddly task. The u nwonted chisel ostectomy technique (Skoog,:1974; McCarthy, 1990; Aiach and Levignac, 1991) was therefore modified and evaluated both experim entally and clinically. The hump is removed in one piece together with the nasal bones up to the horizontal part of the frontonasal suture. To accomplish this, the reduction osteotomy has to be performed in a w ave line fashion. The depth. of resection in the sellion area depends upon the aesthetic planning. In cases with most severe hypertrophy, th e osteotome enters the vertical frontonasal suture behind the nasal bo nes and in front of the nasal spine of the frontal bone, The nasal bon es are disarticulated with a levering movement. Cadaver studies demons trate the safety of the technique: no fracture lines were detected in the frontal process of the maxilla, ethmoid, frontal or lacrimal bones , by either clinical inspection, or by standardised radiological exami nation, The clinical cases show a convincing outcome.