Pentagonal hinge osteotomy for reduction of the wide nasal base of Asians.

We designed a pentagonal hinge osteotomy procedure for reduction of the wide nasal base of Asians. Minimal dissection was performed on the nasal bone and frontal process of the maxilla. Following determination of the desired width of the nose, partial-thickness osteotomy was performed first, using a hand saw at the midlevel from the midline to the lateral osteotomy line. Then, using a guarded osteotome, lateral osteotomy was performed at the piriform aperture. Thus, the lateral border of the triangle was a full-thickness cut, and the medial border was a partial-thickness cut. With digital pressure, lateral parts of triangular segments were moved medially, leaving the medial hinge intact, causing a greenstick fracture. Thereafter, the nasal framework became a pentagonal structure, and the broad nasal base was narrowed. Seven patients (4 males and 3 females; mean age, 24.6 years) underwent surgery. Average follow-up period was 23.8 months. No occurrence of mucosal injury, infection, step deformity, or airway collapse was observed. It is thought that pentagonal hinge osteotomy might be useful for reduction of the wide nasal base of Asians.