Dorsal Hump Reduction Based on the New Ethmoidal Point Classification: A Clinical and Radiological Study of the Keystone Area in 138 Patients.

Dorsal Hump Reduction Based on the New Ethmoidal Point Classification: A Clinical and Radiological Study of the Keystone Area in 138 Patients.:

Related Articles

Dorsal Hump Reduction Based on the New Ethmoidal Point Classification: A Clinical and Radiological Study of the Keystone Area in 138 Patients.

Aesthet Surg J. 2020 Jan 30;:

Authors: Ferreira MG, Dias DR, Cardoso L, Santos M, Sousa CA, Dourado N, Santos J, Amarante J

Abstract

BACKGROUND: Hump resection often requires reorganization of the keystone area.

OBJECTIVES: To describe the importance of the point where the perpendicular plate of ethmoid joins the septal cartilage and the nasal bones (Ethmoidal point) for hump resection surgical planning.

METHODS: Measurements from mid-sagittal slices in nasal computed tomography scans taken in adult Caucasian patients between January 2015 and December 2018 were compared between patients seeking primary rhinoplasty due to a nasal hump and patients not seeking rhinoplasty (control group). Patients with previous nasal surgery or trauma, genetic or congenital facial disorders, and high septal deviation were excluded. The length of overlap between nasal bones and septal cartilage was compared between the two groups. The location of the Ethmoidal point in relation to the beginning of the nasal hump in the cephalocaudal direction was documented in the patients seeking rhinoplasty.

RESULTS:  The study population included 138 patients, 69 seeking and 69 not seeking rhinoplasty (96 females). The mean age was 32.9 years (range, 18-55 years). The length of overlap between nasal bone and septal cartilage was similar between both groups (11.7±3.3 vs 10.8±3.3; p=0.235). The Ethmoidal point was located before the beginning of the nasal hump in 97% (67/69) of nasal hump patients, and it could be found a mean distance of 2.3 (±2.3) mm cephalic to the latter.

CONCLUSIONS: As a rule, the perpendicular plate of the ethmoid does not contribute to the nasal hump, therefore only in exceptional cases should this be addressed while performing dorsal reduction.

PMID: 31996914 [PubMed - as supplied by publisher]