The classical rhinoplasty operation as described by Joseph has been subject to many modifications in the past few years. New procedures and instruments have been introduced which have improved our handling of the cartilaginous portions of the nose. However, no satisfactory technique has as yet been described for narrowing the bony frame-work without the ever-present danger of comminuting or splintering the nasal bones.
A study of the anatomy of the uppermost portion of the nasal skeleton will reveal the inadequacy of our present-day technique. In this region the nasal bone and frontal process of the maxilla attach to the pars nasalis of the frontal bone and are supported on their underneath surfaces by the thick frontal spine, forming one solid plate of bone. This thick plate of bone forms the anterior, or ventral, portion of the nasal skeleton. The thickness of the nasal bones diminishes posteriorly, so that they
GOTTSCHALK GH. THE TRANSVERSE OSTEOTOMY: A NEW RHINOPLASTIC TECHNIQUE. AMA Arch Otolaryngol. 1955;62(3):322–325. doi:10.1001/archotol.1955.03830030088017
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