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The Use of Heanley Bone-Cutting Forceps to Reduce the Thickened and Broad Bony Dorsum in Rhinoplasty
Kunwar Bhatia, MRCS;
Nick S. Jones, MD, FRCS;
Tony R. Bull, FRCS
Arch Facial Plast Surg. 2002;4:186-189.
Heanley bone-cutting forceps can be used in a modified rhinoplasty technique
for patients with nasal bones that are broad and thickened by callus as a
result of several previous nasal fractures. In these patients, the conventional
technique of dehumping followed by medial and lateral osteotomies may leave
a roof of thickened nasal bones due to callus formation that prevents the
pyramid from being narrowed. In this situation, Heanley forceps may be used
instead of medial osteotomies to resect paramedian segments of the remaining
thickness of the nasal bones so that the nasal bones can be medialized. If
no dehumping is required and the bones are just splayed and thickened by callus,
Heanley forceps can be used before infracturing and lateral osteotomies. Several
points are important for the success of this technique, including introducing
the beaks of the forceps submucosally in the correct plane on each side of
the nasal bones, advancing the tips of the forceps as far as the nasion, and
mobilizing the bony segments before performing lateral osteotomies.
From the Department of Otorhinolaryngology, University Hospital, Nottingham
(Drs Bhatia and Jones), and The Royal National Throat, Nose, and Ear Hospital,
London (Dr Bull), England.
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