Linear Impulse Osteotome for Rhinoplasty

Abstract

The 2500 Impactor linear impulse osteotome (MicroAire® Surgical Instruments, Charlottesville, VA) is a new power instrument for the rhinoplasty surgeon. Air pressure drives the osteotome in linear, oscillating pulses, which allows for easy bone cuts. Dorsal hump reduction and a variety of osteotomies were performed on seven cadavers; results were compared with those from traditional osteotome and mallet. Results show equal accuracy and precision, with the degree of soft tissue injury and bone comminution being minimal by each technique. Dorsal hump reduction with the Impactor was performed in a single maneuver starting at the anterior septal angle, cutting easily through the rigid cartilaginous dorsum. The Impactor was used to perform osteotomies on two patients with nasal deformities and satisfactory reductions were achieved. The major distinction with this instrument is the tremendous ease with which bone cuts are made. Minimal pressure is needed as the Impactor advances through bone. In addition, the Impactor offers single operator use and a unique method of reducing a prominent nasal dorsum.