Teaching and practice patterns of lateral osteotomies for rhinoplasty.

PURPOSE: Lateral osteotomies are important during rhinoplasty and represent a challenging technique that otolaryngology and plastic surgery trainees must learn. The approaches for osteotomies are difficult to teach as they are accomplished through tactile feedback. Trends in teaching and practice patterns of lateral osteotomies are poorly described in the literature, and this study aims to fill this knowledge gap. MATERIALS AND METHODS: Members of the American Academy of Facial Plastic and Reconstructive Surgery were surveyed to characterize surgeon preferences for intranasal versus percutaneous lateral osteotomies and understand how techniques are taught. RESULTS: Among surgeons who completed the survey (n=172), 87% reported that they "always" or "mostly" use intranasal lateral osteotomies whereas only 8% "always" or "mostly" use percutaneous approaches. There is no significant trend towards changing osteotomy techniques when teaching trainees. Only 15% of respondents allow trainees to perform lateral osteotomies in more than half of operations. CONCLUSIONS: Most facial plastic surgeons prefer to use intranasal lateral osteotomies. However, many do not allow trainees to perform this critical step during rhinoplasty. This study has implications for both patient care and surgical education.