Chapter 17. Radix Reduction
Patients with excessive anterior protrusion of the nasal bones in the area of the nasion are candidates for reduction of the radix (Figure 17-1).
Figure 17-1. High radix and its correction.
Markings: No specific markings are required; however, a rough estimate of the amount of reduction required should be decided.
Approach: A variety of incisions may be used to approach the radix. Via an open approach, the radix may be accessed via a columellar incision and standard dissection over the lower lateral cartilages and dorsum. Using a closed technique, an intranasal intercartilaginous incision extended along the caudal aspect of the cartilaginous septum may be used to expose the dorsum.
Technique: Dissection proceeds along the dorsal mid-line with a scissors. At the level of the nasal bones, a Freer or key elevator may be used to dissect in a subperiosteal plane. The bony prominence at the nasofrontal angle may then be reduced using a variety of rasps or, if available, a guarded burr, which is exposed only at its inferior, cutting aspect1 (Figure 17-2