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Roozbeh Pahlevan is a specialist for oral and maxillofacial surgery: After he studied dental medicine at Shahid Beheshti University in Tehran/ Iran, he finished his specialist's education at Dental branch of Islamic Azad University in Tehran/ Iran. He is currently working in his private practice in Tehran and Dezful/ Iran. He is also occupied as assistant professor at Cranio-Maxillofacial research center at Dental branch of Islamic Azad University in Tehran/ Iran


Lateral osteotomy is a part of the terminal stages of all complete rhinoplasty operations. It is commonly performed by two methods: the internal continuous and external perforating lateral osteotomies.  Due to least control over the procedure, it is the most damaging step in rhinoplasty. One of the concerns associated with osteotomy is changes such as stenosis, in nasal airway following the surgery.  One of the hypotheses raised to explain the airway stenosis is whether the type of osteotomy could make a difference in the occurrence of nasal airway narrowing.

The purpose of this study is to evaluate the effects of internal and external osteotomy on airway changes following rhinoplasty. Forty patients underwent either internal or external osteotomy, and airway change was determined using three indices: 1) the distance between the most anterior pole of inferior turbinates from nasal septum, analyzed by student t-test, 2) septum position and 3) the medial displacement of nasal bone, which were studied by frequency and percent indices. The distance between the most anterior pole of the inferior turbinates and the nasal septum in external and internal surgeries were 1.13±0.96 and 1.75±1.55 mm on the right and 1.48±0.85 and 1.5±1.39 mm on the left sides, respectively. On the right side, both techniques produced comparable results regarding the septum position. On the left side with external method, septum position was normal, anterior, and posterior in 50.0%, 30.0%, and 20.0%, respectively. While with internal technique, this index was normal in 55%, anterior in 40.0%, and posterior in 5.0%. The medial displacement of nasal bone on the right side was small in both techniques; however, on the left side moderate displacement was seen in 15.0% with internal osteotomy. In conclusion, both techniques produced similar results.