Hump Rasping Using Powered Instruments: A Retrospective Review

Abstract

Background: Nasal hump reduction, a common procedure in rhinoplasty, aims to create a harmonious nasal appearance with smooth dorsal lines. An alternative to traditional osteotomes is the carbide-tip nasal rasp, effective in eliminating modest contour deformities. However, the broad movements and physical forces of manual rasping can significantly weaken the osseocartilaginous vault. Power-assisted instruments have been used to reduce soft tissue trauma. Although long-term clinical outcomes of power-assisted instrumentation are pending, initial reports have been positive. Methods: This retrospective chart review encompassed 220 consecutive rhinoplasty cases conducted by the senior author, all involving women aged 19–37 years. Excluding 80 cases that did not involve bone reduction, the analysis concentrated on 140 patients who underwent bone reduction procedures. The success of nasal hump reduction was evaluated based on the joint satisfaction of both the patient and the surgeon with the surgical improvement. Results: The open rhinoplasty approach was predominantly used for surgical exposure to minimize inadvertent rasping of the nasal cartilage. Among the 140 patients undergoing power-assisted bone removal, all but five achieved an initially satisfactory refinement of the bony nasal contour. Notably, no serious complications were observed throughout the study. Unfortunately, one patient did not comply with the monthly steroid injections, leading to the necessity of revision surgery for the removal of regenerated bone. Conclusion: The integration of power-assisted instrumentation in rhinoplasty procedures represents a promising advancement, addressing challenges associated with traditional methods.