Hybrid Osteoplasty Versus Osteotomy in Rhinoplasty

NCT ID: NCT07142525

Last Updated: 2025-10-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2026-12-01

Brief Summary

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This study is designed to compare two common techniques for reducing the nasal hump during rhinoplasty: the traditional method using osteotomes and rasps, and a newer technique called hybrid osteoplasty that uses a surgical drill. Both approaches aim to improve the appearance and function of the nose. The trial will measure pain, swelling, bruising, and the smoothness of the nasal bridge, as well as patient satisfaction and breathing outcomes. Participants will be followed for one year to assess both early healing and long-term results.

Detailed Description

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This prospective randomized controlled trial will evaluate the aesthetic and functional outcomes of hybrid osteoplasty using a surgical burr compared with traditional osteotomy and rasping in primary open rhinoplasty patients presenting with dorsal humps. The study population consists of adults without prior nasal surgery, trauma, or congenital deformities. Patients are randomized into two groups: Group A (hybrid osteoplasty) and Group B (traditional osteotomy plus rasping).

The primary objective is to assess differences in postoperative pain, edema, ecchymosis, dorsal smoothness, contour regularity, and patient satisfaction. Secondary outcomes include functional improvement measured by the Nasal Obstruction Symptom Evaluation (NOSE) score, aesthetic satisfaction assessed by the Rhinoplasty Outcome Evaluation (ROE), and the rate of revision surgery within 12 months.

Follow-up assessments are scheduled on postoperative Days 1, 2, and 7, and at 1, 3, 6, and 12 months. Standardized photographic documentation will support aesthetic evaluation, while clinical scoring systems will provide objective and subjective outcome data. The trial is powered to identify whether hybrid osteoplasty offers advantages in contour refinement and reduced soft tissue trauma compared with conventional osteotomy-based approaches.

Conditions

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Rhinoplasty Techniques

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Hybrid Osteoplasty

Participants undergo dorsal hump reduction using a surgical burr (drill) without traditional dorsal osteotomy. The technique allows controlled bone contouring under direct visualization.

Group Type EXPERIMENTAL

Hybrid Osteoplasty

Intervention Type PROCEDURE

Open rhinoplasty with dorsal hump reduction performed using a powered surgical burr under irrigation and direct visualization. Bone is contoured gradually to achieve a smooth dorsum while preserving the keystone area. No dorsal osteotomy is performed in this arm. Cartilaginous work and adjunctive steps (e.g., septoplasty or tip refinement) are performed as clinically indicated but are not part of the intervention being tested.

Traditional Osteotomy and Rasping

Participants undergo dorsal hump reduction using the conventional method of osteotomy combined with rasping. This is the established standard approach for contouring the nasal dorsum.

Group Type ACTIVE_COMPARATOR

Traditional Osteotomy and Rasping

Intervention Type PROCEDURE

Open rhinoplasty using the conventional technique for dorsal hump reduction. The bony hump is resected with a straight osteotome, followed by manual rasping to refine the nasal dorsum, with preservation of the keystone area. Powered burrs are not used for primary dorsal contouring in this arm. Cartilaginous work and adjunctive procedures may be performed as clinically indicated but are not part of the tested intervention.

Interventions

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Hybrid Osteoplasty

Open rhinoplasty with dorsal hump reduction performed using a powered surgical burr under irrigation and direct visualization. Bone is contoured gradually to achieve a smooth dorsum while preserving the keystone area. No dorsal osteotomy is performed in this arm. Cartilaginous work and adjunctive steps (e.g., septoplasty or tip refinement) are performed as clinically indicated but are not part of the intervention being tested.

Intervention Type PROCEDURE

Traditional Osteotomy and Rasping

Open rhinoplasty using the conventional technique for dorsal hump reduction. The bony hump is resected with a straight osteotome, followed by manual rasping to refine the nasal dorsum, with preservation of the keystone area. Powered burrs are not used for primary dorsal contouring in this arm. Cartilaginous work and adjunctive procedures may be performed as clinically indicated but are not part of the tested intervention.

Intervention Type PROCEDURE

Other Intervention Names

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Drill-Assisted Dorsal Hump Reduction Power-Assisted Osteoplasty Burr Osteoplasty Osteotome + Rasp Technique Conventional Dorsal Hump Reduction

Eligibility Criteria

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Inclusion Criteria

* Primary open rhinoplasty planned.
* Dorsal hump with bony or mixed component suitable for either technique.
* No prior nasal surgery or significant nasal trauma affecting dorsum.
* ASA I-III and fit for general anesthesia.
* Willing to provide written informed consent, including standardized photography.
* Able and willing to attend all follow-up visits through 12 months.

Exclusion Criteria

* Revision rhinoplasty or prior osteotomy/osseocartilaginous work.
* Active infection, open lesions, or uncontrolled dermatologic conditions at operative field.
* Bleeding diathesis, platelet disorder, INR elevation, or anticoagulant/antiplatelet therapy that cannot be paused.
* Uncontrolled systemic disease (e.g., hypertension, diabetes) or ASA ≥ IV.
* Pregnancy or breastfeeding.
* Chronic isotretinoin use within past 6 months or long-term systemic corticosteroid use.
* Concurrent interventional study that may affect healing or outcomes.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sulaimani

OTHER

Sponsor Role lead

Responsible Party

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Assoc. Prof. Dr. Goran Latif Omer

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Goran L Omer, PhD

Role: STUDY_CHAIR

University of Sulaimani

Locations

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Royal Hospital

Sulaymaniyah, KRI, Iraq

Site Status

Countries

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Iraq

Central Contacts

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Goran L Omer, PhD

Role: CONTACT

+9647721524848

Sahand S. Ali, MD

Role: CONTACT

+9647729968844

Facility Contacts

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Akam Sarbaz

Role: primary

+9647702295220

References

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Azizli E, Bayar Muluk N, Dundar R, Cingi C. A new preservation technique for dehumping the dorsum. Eur Rev Med Pharmacol Sci. 2023 Mar;27(2 Suppl):57-62. doi: 10.26355/eurrev_202303_31703.

Reference Type BACKGROUND
PMID: 36971222 (View on PubMed)

Ferreira MG, Monteiro D, Reis C, Almeida e Sousa C. Spare Roof Technique: A Middle Third New Technique. Facial Plast Surg. 2016 Feb;32(1):111-6. doi: 10.1055/s-0035-1570503. Epub 2016 Feb 10.

Reference Type BACKGROUND
PMID: 26862972 (View on PubMed)

Aldosari BF, Alhajress RI, Bogari AO. Hump Rasping Using Powered Instruments: A Retrospective Review. Plast Reconstr Surg Glob Open. 2024 Sep 10;12(9):e6153. doi: 10.1097/GOX.0000000000006153. eCollection 2024 Sep.

Reference Type BACKGROUND
PMID: 39258281 (View on PubMed)

Lal GN, Ghosh P. Use of drill in rhinoplasty (a case report). Indian J Otolaryngol Head Neck Surg. 1999 Jan;51(1):90-2. doi: 10.1007/BF02996859.

Reference Type BACKGROUND
PMID: 23119498 (View on PubMed)

Goodman WS. The rotating burr in rhinoplasty. Arch Otolaryngol. 1981 Jul;107(7):436-8. doi: 10.1001/archotol.1981.00790430038010. No abstract available.

Reference Type BACKGROUND
PMID: 7247809 (View on PubMed)

Avashia YJ, Marshall AP, Allori AC, Rohrich RJ, Marcus JR. Decision-Making in Middle Vault Reconstruction following Dorsal Hump Reduction in Primary Rhinoplasty. Plast Reconstr Surg. 2020 Jun;145(6):1389-1401. doi: 10.1097/PRS.0000000000006850.

Reference Type BACKGROUND
PMID: 32195860 (View on PubMed)

Barrett DM, Casanueva F, Wang T. Understanding Approaches to the Dorsal Hump. Facial Plast Surg. 2017 Apr;33(2):125-132. doi: 10.1055/s-0037-1598033. Epub 2017 Apr 7.

Reference Type BACKGROUND
PMID: 28388791 (View on PubMed)

Fuller JC, Hilger PA. Modified Skoog Method for Hump Reduction. Facial Plast Surg Clin North Am. 2021 Feb;29(1):131-139. doi: 10.1016/j.fsc.2020.09.008.

Reference Type BACKGROUND
PMID: 33220838 (View on PubMed)

Sowder JC, Thomas AJ, Gonzalez CD, Limaye NS, Ward PD. Use of Spreader Flaps Without Dorsal Hump Reduction and the Effect on Nasal Function. JAMA Facial Plast Surg. 2017 Jul 1;19(4):287-292. doi: 10.1001/jamafacial.2016.2057.

Reference Type BACKGROUND
PMID: 28241228 (View on PubMed)

Azizzadeh B, Reilly M. Dorsal Hump Reduction and Osteotomies. Clin Plast Surg. 2016 Jan;43(1):47-58. doi: 10.1016/j.cps.2015.09.022. Epub 2015 Oct 23.

Reference Type BACKGROUND
PMID: 26616694 (View on PubMed)

Roostaeian J, Unger JG, Lee MR, Geissler P, Rohrich RJ. Reconstitution of the nasal dorsum following component dorsal reduction in primary rhinoplasty. Plast Reconstr Surg. 2014 Mar;133(3):509-518. doi: 10.1097/01.prs.0000438453.29980.36.

Reference Type BACKGROUND
PMID: 24263393 (View on PubMed)

Rohrich RJ, Muzaffar AR, Janis JE. Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty. Plast Reconstr Surg. 2004 Oct;114(5):1298-308; discussion 1309-12. doi: 10.1097/01.prs.0000135861.45986.cf.

Reference Type BACKGROUND
PMID: 15457053 (View on PubMed)

Other Identifiers

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No. 159 (August 17th, 2025)

Identifier Type: -

Identifier Source: org_study_id

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