The Use of Microdebrider in Reduction Rhinoplasty

Kim, Seon Tae; Song, Se Ho; Ko, Sang Hyun; Park, Jung Soo; Chung, Yoo Sam; Cha, Heung Eog

Abstract

BACKGROUND AND OBJECTIVES: Surgeons commonly employ osteotome and rasp to remove the bony hump of the nasal dorsum in reduction rhinoplasty. The thickness of skin-soft tissue envelope and nasal bone is not consistent in nasal dorsum. Therefore, the tendency is to over-resect at the rhinion and under-resect at the nasofrontal angle, thereby leaving an excessive amount of thicker superior nasal bone. Manual rasps can cause avulsion injury of upper lateral cartilage and soft tissue trauma. So we introduced a powered instrument (microdebrider) in reduction rhinoplasty to improve precision and technical ease while minimizing tissue trauma.
SUBJECTS AND METHOD
We operated on eleven patients either with hump nose only (N=6) or deviated nose with hump (N=5). Endonasal approach was used in 3 cases and external approach in 8 cases. We used the microdebrider only for 5 cases and microdebrider after osteotome for 6 cases to smoothen the dorsal edges of open roof after osteotome. We used the powered instrument XPS 2000 Microresector system for rhinoplsty (XOMED(R)).
RESULTS
Ten patients were satisfied with the results subjectively. Bony irregularity of the nasal dorsum was not observed and we found less eccyhmosis and edema compaired with the usage of rasp.
CONCLUSION
A microdebrider offers a precise alternative to the rasp and can be used in a more precise and limited fashion in reduction rhinoplasty with reduced complication than rasp.