Comparison of two approaches to lateral nasal osteotomy in Saudi patients

Abstract

BACKGROUND: Nasal deformity is an abnormality in the appearance of the nose due to either congenital defect or trauma. In traumatic cases, patients often present with combined functional and cosmetic complaints. Therefore, otolaryngologists take into account both breathing and aesthetic nasal issues. OBJECTIVES: To evaluate the changes in the nasal dorsum and base; compare breathing and aesthetic satisfaction scores between two approaches to lateral nasal osteotomy: low-to-low and low-to-high. DESIGN: Comparative observational; data gathered retrospectively and prospectively. SETTING: Head and Neck and Skull Base Center, King Abdullah Medical City, Makkah, Saudi Arabia. PATIENTS AND METHODS: Patients who received hump reduction rhinoplasty from 2013 to 2016 met the inclusion criteria. MAIN OUTCOME MEASURE(S): The differences in dorsal (DW) and ventral (VW) widths with a fixed interpupillary distance (IPD). Satisfaction scores for both cosmetic perspective and breathing functionality. RESULTS: We included 46 patients; 28 patients underwent low-to-low osteotomy and 18 patients underwent low-to-high osteotomy. With both approaches, there were statistically decreases from preoperative to postoperative ratios of VW/IPD and DW/IPD. However, differences in DW/IPD ratio and VW/IPD ratio (pre- versus post-op) were significantly higher in the low-to-low group (P<.0001). All showed breathing satisfaction postoperatively regardless of the operative approach. Only patients who underwent the low-to-high osteotomy were neutral or dissatisfied with aesthetic sensibility. CONCLUSION: Both types of osteotomy showed a satisfactory outcome in both objective and subjective measures. However, low-to-low osteotomy was superior in pre- to post-operative differences in DW/IPD and VW/IPD ratios. LIMITATIONS: Sampling was by convenience. The study was conducted in a single tertiary center and was a small sample.