Abstract
One of the most common components of most dorsal preservation (DP) techniques is subdorsal
septal excision. Whatever the instrument used for this procedure (piezoelectric, Rongeur,
or long scissors), it is paramount to be able to determine the exact subdorsal point
(SDoP) at which the osteotomy/ostectomy (or cartilage cut) has been reached. First,
to avoid any unnecessary extension of the osteotomy that increases the risk of fracture
spreading into the cribriform plate and a consequent cerebrospinal fluid leak; second,
to be sure that the subdorsal cut is high enough and can be combined/unified with
the planned radix osteotomy.
In addition, transverse osteotomies are usually necessary in both preservation and
structural rhinoplasties. Even though many surgeons are satisfied with their osteotomy
lines, it sometimes proves difficult to be sure of their position, especially during
a DP rhinoplasty when both the transverse lines have to go in the direction of the
planned radix osteotomy.
We have developed the Nasal Locator (NL) to precisely define various nasal points
of interest, such as a subdorsal cut (cartilaginous or bony), or a transverse or medial
osteotomy line. It ends in two tips. The lower tip is placed at the point we wish
to determine (e.g., SDoP or a transverse osteotomy), while the upper tip is fixed
a certain distance from it (in all three dimensions), showing its exact location.
Our in-depth research of the literature and the market has not revealed any device
similar in form and function to the NL.
We have been using the NL for almost 2 years and are confident of its usefulness.
It is easy to use, and practically no time is needed to become familiar with it. During
surgery, it is needed for less than 30 seconds and is risk-free. It is fully sterilizable
and can be used repeatedly.
Keywords
nasal locator - subdorsal point - dorsal preservation - preservation rhinoplasty -
structural rhinoplasty - instrument
