Technical note: "look-ahead" navigation method for K-wire fixation in rhinoplasty. |
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Authors: | Kenneth K Kim Linping Zhao Peter Belafsky Pravin K Patel E Bradley Strong |
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Affiliation: | Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois, USA. |
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Abstract: | OBJECTIVE: The Kirschner wire (K-wire) technique for fixation of rib cartilage grafts to the maxilla is a powerful tool in rhinoplasty. It gives the nose unparalleled anterior projection. However, the technique is challenging because of poor maxillary visualization through the open rhinoplasty approach. Inaccurate K-wire placement can cause dental injury or violation of the nasal/palatal mucosa. This study evaluates the efficacy of a surgical navigation system to guide K-wire placement. STUDY DESIGN: K-wires were placed, through an open rhinoplasty approach, into the maxilla of 12 fresh cadaver heads by a single surgeon. Six control specimens had K-wires placed without navigation. Six treatment specimens had K-wires placed with the "look-ahead navigation method," in which a surgical navigation device was attached to the K-wire gun. All maxillae were then sectioned to determine the final location of the K-wires. RESULTS: Four out of five (80%) of the K-wires were successfully placed in the treatment group, although only 3 out of 6 (50%) of the K-wires were successfully placed in the control group. One treatment K-wire was dislodged during the sectioning process and had to be excluded. The average K-wire deviation in the axial plane was less for the treatment group (0.2 +/- 0.4 mm) than for the control group (1.8 +/- 1.5 mm; P < .05). CONCLUSION: When surgical navigation is used in K-wired cartilage strut graft placement to maxilla, it can improve the accuracy of K-wire placement. This may result in reduced complications due to errant K-wire placement. |
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