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Objectives/hypothesis: To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection.Study Design: Retrospective pilot study combined with cross-sectional survey.Methods: A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware.Results: Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location.Conclusion: This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair.Level Of Evidence: 4. Laryngoscope, 2016 127:331-336, 2017. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Rhinoplasty often requires precise, graded bone removal without damage to surrounding nasal soft tissue and mucosa. Unfortunately, current techniques are associated with decreased visualization, heat generation, mechanical chatter, and lack of surgical precision with resultant soft tissue injury. We introduce a novel technique to sculpt the nasal dorsum in a precise fashion with the ultrasonic bone aspirator and delineate its advantages over conventional techniques. Study Design: Retrospective chart review. Methods: The SONOPET ultrasonic bone aspirator (Mutoh Co., Ltd., Tokyo, Japan) utilizes ultrasonic waves to emulsify bone with concurrent irrigation and suction, enabling precise, graded bone removal under direct visualization without thermal or mechanical injury to the surrounding soft tissue or mucosa. We describe the application of this technology to dorsal hump reduction with early follow-up to 9 months. Successful reduction was determined by the senior author at postoperative follow-up appointments. Results: Sixty patients underwent open rhinoplasty requiring dorsal reduction with the ultrasonic bone aspirator. No individuals experienced delayed healing, infection, scarring, or major complications. Five of 60 patients had minor post surgical irregularities, which included visible nasal dorsum deformity, palpable nasal deformity, under-resection of the dorsum, and asymmetry of the nasal dorsum. No postoperative open sky deformities, inverted “V” deformities, over-resected dorsums, or skin injuries were observed. Conclusions: Ultrasonic bone aspiration permits safe, precise, graded bone removal without damaging surrounding nasal soft tissue and mucosa. We introduce novel applications of the ultrasonic bone aspirator in dorsal reduction that provide significant advantages over conventional techniques. Laryngoscope, 2010 [ABSTRACT FROM AUTHOR]

A response by Edmund A. Pribitkin and colleagues to a letter to the editor regarding their article on sonic rhinoplasty is presented.