Computer-Assisted Planning and Navigation of Osteotomies in Rhinoplasty: An Innovative Technique.

[OBJECTIVES] Rhinoplasty is among the most commonly performed esthetic surgeries globally, with osteotomies playing a critical role in modifying nasal bone structure. The ideal osteotomy procedure aims for precision and minimal complications. Although navigation systems have advanced in various surgical fields, their use in rhinoplasty is still developing. Our primary objective is to assess the feasibility of computer-assisted planning and navigation for osteotomies in primary rhinoplasty, following the IDEAL Phase 2a framework. Secondary objectives are to assess safety and efficacy.

[METHODS] Conducted in a tertiary center, this retrospective study involved 20 patients undergoing primary rhinoplasty with planning and navigation assistance. Navigation systems were used to plan and perform lateral, medial, and transverse osteotomies using real-time guidance from a tracked piezoelectric instrument.

[RESULTS] For our first 20 patients, all procedures were completed without reverting to traditional techniques. Throughout the study, performing osteotomies became easier, but the transverse osteotomy remained more challenging than medials and laterals. Between the first and the last patient, the duration of preoperative planning decreased from 38.4 to 20 min. Significant postoperative improvements were observed for FACE-Q, NOSE, and MiRa scale scores. Two cases of blisters related to the subcutaneous use of the piezoelectric instrument were independent of the navigation system.

[CONCLUSION] Computer-assisted navigation in nasal osteotomies is feasible, safe, and effective, enhancing surgical precision and patient outcomes. The study's limitations, such as its retrospective nature and small sample size, suggest a need for larger, prospective studies to validate these findings and compare this method with traditional techniques.

[LEVEL OF EVIDENCE] Level 3. RnIPH 2023-105.