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The perforating chisel (Fig. 1) was developed as an aid to producing the nasal fracture after lateral osteotomy during the course of a complete rhinoplasty. Techniques to produce this fracture vary. Some surgeons outfracture with a chisel between the nasal bones. Others use heavy pressure with the thumb, producing the fracture. Sometimes this fracture occurs very readily, but at times great pressure is exerted and still it does not occur. At other times, the fracture line may occur in an irregular manner which one cannot control. In order to overcome this, I developed this instrument, which is used somewhat like an awl. A series of perforations are placed in the nasal bone, from the external limit of the nasal bone to the region of the inner canthus, where the lateral osteotomy ends. After the perforations (which vary from one to three) are made, it is then easy to complete the
MYERS D. A PERFORATING CHISEL FOR COMPLETING NASAL FRACTURE: A New Instrument for Use in Rhinoplasty. AMA Arch Otolaryngol. 1955;61(4):475–476. doi:10.1001/archotol.1955.00720020491017
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