Rationale for osteotome selection in rhinoplasty

Proper selection of an osteotome for nasal osteotomy is important for minimizing soft tissue trauma. Radiographic analysis of the facial bony lateral wall thickness was performed to suggest a guideline for an appropriate osteotome size for Asians. Facial bone computed tomography (CT) of 100 patients (50 male, 50 female) were studied. The thickness of the facial bony lateral wall at three points along the track of a lateral osteotomy, and two points along the track of a medial osteotomy and intermediate osteotomy were measured. The average bony thickness along the track of a lateral osteotomy was 2.61 +/- 0.66 mm at the low level, 2.75 +/- 0.76 mm at the middle level, and 2.72 +/- 0.53 mm at the high level in subjects. The average bony thickness along the track of an intermediate osteotomy were 1.26 +/- 0.34 mm at the low level, and 1.31 +/- 0.32 mm at the high level in the subjects. The average bony thickness along the track of the medial osteotomy were 2.54 +/- 0.31 mm at the low level, and 2.77 +/- 0.30 mm at the high level in subjects. These results may provide a guideline for choosing an osteotome of appropriate size for the Asian population.