Osteotomies in rhinoplasty surgery.

PURPOSE OF REVIEW: To review the current literature on nasal osteotomies with an emphasis on new techniques as well as evaluations of existing procedures. RECENT FINDINGS: Powered instrumentation has seen greater use and is felt to offer an improvement by some over more traditional methods. The enbloc osteotomy may be an alternative procedure to straighten a deviated bony dorsum that does not require hump reduction. Osteotomy sequence can have a significant effect on final outcomes. Comparisons of continuous vs. perforating osteotomy shows only a difference in ecchymosis and edema rather than effectiveness. SUMMARY: The often frustrating and inconsistent nasal osteotomy has been carefully scrutinized by many surgeons over the years. Evolutionary improvements have been developed that may reduce outcome variability and enhance reliability.