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Facial Plast Surg 1997; 13(4): 291-297
DOI: 10.1055/s-0028-1082428
© 1998 by Thieme Medical Publishers, Inc.

Powered Instrumentation for Dorsal Reduction

Daniel G. Becker1 , Dean M. Toriumi2 , Charles W. Gross3 , M. Eugene Tardy4  Jr. 
  • 1Division of Rhinology & Facial Plastic and Reconstructive Surgery, Dept of Otolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia Pennsylvania
  • 2Dept. of Otolaryngology-Head & Neck Surgery, University of Illinois at Chicago, Chicago, Illinois
  • 3Dept. of Otolaryngology-Head & Neck Surgery, University of Virginia Medical Center, Charlottesville, Virginia
  • 4Dept. of Otolaryngology-Head & Neck Surgery, University of Illinois at Chicago, and Tardy Facial Plastic Surgery Institute, Chicago, Illinois
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Publication Date:
29 July 2008 (online)

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ABSTRACT

We describe the use of powered instrumentation for precise modification of the bony nasal dorsum. Specific modifications were made to design a drill specifically for the bony nasal dorsum. This drill has a protective sheath that covers all but the active part of the drill, protecting the skin-soft tissue envelope, and it also has suction at the resection site. In some cases an osteotome is used to reduce the hump and the drill is used to achieve additional reduction and to smooth the exposed edges under direct vision. In other cases the entire bony hump is reduced using the drill.

The nasal dorsum drill offers a precise alternative to the rasp. The precision of the drill is highlighted in cases in which limited reduction is needed, as in cases of a single or several spicules requiring reduction and smoothing after osteotomy, or a single 4 mm raised area requiring limited reduction. The design of rasps makes it difficult to work on these focal areas without unnecessarily rasping surrounding areas, whereas the drill may be used to reduce the entire hump, to smooth the edges after osteotomy, or in a more precise and limited fashion when indicated. The drill may be less traumatic to the skin-soft tissue envelope because it does not rely on the potentially bruising back and forth motion typical of rasping. The nasal dorsum drill may decrease the incidence of bony dorsal irregularities after rhinoplasty.

KEY WORDS

powered instrumentation - protective sheath - suction-irrigation - bony nasal dorsum