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25-09-2011 | Article

Ultrasonic bone aspirator improves precision of rhinoplasty


Free abstract

MedWire News: Study results suggest that use of an ultrasonic bone aspirator, which allows surgeons to remove bone without damaging surrounding tissue, may improve precision of rhinoplasty.

Traditionally used tools for rhinoplasty, such as the osteome, Joseph bone saw, and carbide rasp, all have significant limitations. For example, their use can result in comminution, asymmetry, rocker deformities, or damage to surrounding tissue or cartilage, especially if subtle or refined alterations are required.

The ultrasonic bone aspirator has recently been developed for use in neuro- and orthopedic surgery to allow precise removal of bone without incurring soft tissue damage.

To assess the effectiveness of the ultrasonic tool for refining rhinoplasty techniques, Jewel Greywoode and Edmund Pribitkin from Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA followed-up 103 consecutive patients undergoing cosmetic rhinoplasty at an academic facial plastic surgery practice.

All the procedures involved use of the ultrasonic bone aspirator. It was used successfully to reduce the nasal spine, for glabellar deepening, for sculpting mobile bone fragments and smoothing bony edges after osteotomy, and for reducing the convexity of nasal bones.

The researchers performed histologic analysis of cartilage samples, and the patient and surgeon subjectively evaluated the aesthetic outcome of the procedure.

All the patients achieved satisfactory outcomes, although seven did experience minor complications. These included one patient with a visible dorsal irregularity, two with palpable but not visible dorsal irregularities, two with asymmetry of the dorsum, and two with underresection of the dorsum.

Of note, no patients experienced skin or soft-tissue injury as a result of the procedure.

"The multiple applications of this device make it an attractive tool for rhinoplasty," write Greywoode and Pribitkin in the Archives of Facial Plastic Surgery. "The main drawbacks of the ultrasonic bone aspirator for cosmetic rhinoplasty include cost, time, and limited usefulness via an endonasal approach."

They conclude: "Multiple applications in nasal surgery can be found, and although long-term results are lacking, the device's positive safety profile and early results warrant further use and investigation."

By Helen Albert