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. 2020 Sep;78(9):1630.e1-1630.e10.
doi: 10.1016/j.joms.2020.04.015. Epub 2020 Apr 18.

Concomitant Dorsal Preservation Rhinoplasty and Orthognathic Surgery: A Technical Note

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Concomitant Dorsal Preservation Rhinoplasty and Orthognathic Surgery: A Technical Note

Seied Omid Keyhan et al. J Oral Maxillofac Surg. 2020 Sep.

Abstract

Purpose: In the present report, we have introduced a novel technique for concomitant Le Fort I surgery and dorsal preservation rhinoplasty and reviewed the reported data.

Patients and methods: Concurrent surgery could be considered a suitable option for patients requiring both upper jaw orthognathic surgery and rhinoplasty or those who are willing to undergo single-stage concomitant rhinoplasty and orthognathic surgery. In the present technical note, we have introduced a dorsal preservation rhinoplasty technique combined with Le Fort I surgery through an intraoral approach. The advantages of this technique include its conservative design, avoidance of a second surgery and anesthetic, the ability to correct possible nasal defects caused by the Le Fort I osteotomy, keeping the keystone area intact, and, most importantly, the possibility of concomitant surgery. However, recurrence of the hump and nasal pyramid lateralization are among the problems that could be associated with this technique. These disadvantages might necessitate revision surgery.

Results: A total of 48 patients (23 females and 15 males) had undergone concomitant rhinoplasty and Le Fort I surgery using a modified dorsal preservation technique. No patient reported dissatisfaction with the results of surgery regarding the nasal and facial esthetics. No evidence of severe complications, such as saddle nose, severe deviation, airway compromise, or severe asymmetry, was observed postoperatively.

Conclusions: Based on our experience with patients and after at least 1 year of follow-up, the results of the present study suggest that this technique is straightforward and produces excellent results.

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