Surgical protocol for a safe lateral nasal wall osteotomy

Purpose: The purpose of this study was to define the anatomy and anatomic variations of the lateral nasal wall area to identify safe access points, determine the optimum osteotomy line for Le Fort I osteotomies, and define a surgical protocol. Materials and Methods: The angulations and widths of 160 lateral nasal walls and the distances of the greater palatine canal were measured on axial images from coronal sections 5 mm over the deepest point of the nasal base. Results: The average angle between the anterior lateral nasal wall and the medial maxillary sinus wall was 160 degrees in females and 165.67 degrees in males for the right and 155.90 degrees in females and 163.22 degrees in males for the left side. Statistically significant differences were found in the lengths, angulations, and widths of the lateral nasal walls between females and males. Conclusion: This study described the mean angulations and linear distances between anatomic structures of the lateral nasal wall and it defines the "Medipol protocol" for a safe osteotomy.The International Society of Craniofacial Surger