Journal of Craniomaxillofacial Research 2017. 4(1):289-295.

Evaluation of the effect of internal and external osteotomy on the amount of mucosal rupture, edema, and ecchymosis in rhinoplasty
Masoud Yazdani, Behnam Bohluli, Farzin Sarkarat, Amin Nowruzi, Zeinab Davoudmanesh


Introduction: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump with the edema and ecchymosis being the major sequels of the operation. The present study compared post-operative edema and
ecchymosis and mucosa tears between internal and external osteotomy techniques.
Materials and Methods: In a prospective double-blind randomized clinical trial, 20 cases underwent internal and 20 cases underwent external lateral osteotomies from the candidates of rhinoplasty in the Gundi Clinic. Mucosal tears were measured by millimeters and edema and ecchymosis
severity were scored by a 4-scaled measure on 7 days after surgery. Mucosal tears of the groups were analyzed by Exact Fisher test while the edema and ecchymosis scores of both groups were subjected to Mann-whitney U test.
Results: In the internal and external techniques; 6 (30.0%) and 4 (20.0%) showed mucosal tears on both sides respectively. In the right sides of the patients underwent internal osteotomy; the edema and ecchymosis grades of +, ++, +++ and ++++ were observed in 1 (5.0%); 9 (45.0%); 8 (40.0%)
and 2 (10.0%) while these values were 2 (10.0%); 8 (40.0%); 8 (40.0%) and 2 (10.0%) in the left sides in these patients. In the right sides of the patients in external group; edema and ecchymosis grades of +, ++, and +++ were shown in 3 (15.0%); 12 (60.0%); and 5 (25.0%) while the values
were 4 (20.0%); 11 (55.0%); and 5 (25.0%) in the left sides of them. Although with lower grades of associated complications in the external technique; no significant differences were observed
between 2 modalities.
Conclusion: Although with no significant differences; external osteotomy seems to be the approach
of choice for the plastic surgeries of the nose and correction of bone deformities due to the lower values of edema and ecchymosis and mucosal tears as well as the simple performance of the technique.
Key words: Rhinoplasty, Internal lateral osteotomy, External lateral osteotomy, Mucosal tears, Edema and eccymosis.


Rhinoplasty; Internal lateral osteotomy; External lateral osteotomy; Mucosal tears; Edema and eccymosis

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