Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T19:38:00.884Z Has data issue: false hasContentIssue false

Is angular artery trauma seen frequently in lateral osteotomy and responsible for peri-orbital ecchymosis?

Published online by Cambridge University Press:  12 January 2021

Z Onerci Altunay
Affiliation:
Department of Otorhinolaryngology, Haseki Education and Training Hospital, İstanbul, Turkey
T M Onerci*
Affiliation:
Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey
*
Author for correspondence: Dr T Metin Onerci, Güniz Sokak 38-5 Kavaklıdere, 06700Ankara, Turkey E-mail: [email protected] Fax: +90 312 468 6268

Abstract

Objective

This study was performed on fresh frozen cadavers to investigate the role of angular artery damage.

Methods

Lateral osteotomies (‘high-low-high’ method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.

Results

The angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.

Conclusion

The high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr T M Onerci takes responsibility for the integrity of the content of the paper

References

Erişir, F, Tahamiler, R. Lateral osteotomies in rhinoplasty: a safer and less traumatic method. Aesthet Surg J 2008;28:518–20CrossRefGoogle ScholarPubMed
Cochran, CS, Landecker, A. Prevention and management of rhinoplasty complications. Plast Reconstr Surg 2008;122:60–7CrossRefGoogle ScholarPubMed
Ozkose, M, Baykan, H, Coşkuner, İ. The effect of patient positioning on amount of intraoperative bleeding in rhinoplasty: a randomized controlled trial. Aesthetic Plast Surg 2016;40:453–7CrossRefGoogle ScholarPubMed
Hwang, SH, Lee, JH, Kim, BG, Kim, SW, Kang, JM. The efficacy of steroids for edema and ecchymosis after rhinoplasty: a meta-analysis. Laryngoscope 2015;125:92–8CrossRefGoogle ScholarPubMed
Yu, D, Weng, R, Wang, H, Mu, X, Li, Q. Anatomical study of forehead flap with its pedicle based on cutaneous branch of supratrochlear artery and its application in nasal reconstruction. Ann Plast Surg 2010;65:183–7CrossRefGoogle ScholarPubMed
Kılıc, C, Tuncel, U, Comert, E, Sencan, Z. Effect of the rhinoplasty technique and lateral osteotomy on periorbital edema and ecchymosis. J Craniofac Surg 2015;26:430–3CrossRefGoogle ScholarPubMed
Gryskiewicz, JM, Gryskiewicz, KM. Nasal osteotomies: a clinical comparison of the perforating methods versus the continuous technique. Plast Reconstr Surg 2004;113:1445–56CrossRefGoogle ScholarPubMed
Saedi, B, Sadeghi, M, Fekri, K. Comparison of the effect of corticosteroid therapy and decongestant on reducing rhinoplasty edema. Am J Rhinol Allergy 2011;25:141–4CrossRefGoogle ScholarPubMed
Ong, AA, Farhood, Z, Kyle, AR, Patel, KG. Interventions to decrease postoperative edema and ecchymosis after rhinoplasty: a systematic review of the literature. Plast Reconstr Surg 2016;137:1448–62CrossRefGoogle ScholarPubMed
Bailey, BJ, Nahum, AM. Oxyphenbutazone (Tandearil) in rhinoplasty: a clinical evaluation of effectiveness. Calif Med 1966;105:271–5Google ScholarPubMed
Berinstein, TH, Bane, SM, Cupp, CL, DeMarco, JK, Hunsaker, DH. Steroid use in rhinoplasty: an objective assessment of postoperative edema. Ear Nose Throat J 1998;77:40–3CrossRefGoogle ScholarPubMed
El-Sisi, H, Abdelwahab, M, Most, SP. Association of periosteal sweeping vs periosteal preservation with early periorbital sequelae among patients undergoing external perforating osteotomy during rhinoplasty. JAMA Facial Plast Surg 2019;21:185–90CrossRefGoogle ScholarPubMed
Kara, CO, Kara, IG, Yaylali, V. Subconjunctival ecchymosis due to rhinoplasty. Rhinology 2001;39:166–8Google ScholarPubMed
Al-Arfaj, A, Al-Qattan, M, Al-Harethy, S, Al-Zahrani, K. Effect of periosteum elevation on periorbital ecchymosis in rhinoplasty. J Plast Reconstr Aesthet Surg 2009;62:538–9CrossRefGoogle ScholarPubMed