Lateral rhinotomy

By

Dr. T. Balasubramanian M.S. D.L.O

Definition: This surgical procedure provides adequate exposure to the inside of the nasal cavity, upper midface, nasal root, and the ethmoids.  This surgery was first described by Michaux in 1853 and later perfected by Moure.

Indications:

1. To remove benign tumors involving the nose and para nasal sinuses

2. To remove impacted nasal foreign bodies from the nasal cavity

3. Variations of this incision can be used to perform maxillectomy


Incision:  The incision is named after Moure (Moure's lateral rhinotomy).  The incision is started from the inner extremity of the eyebrow, descending along the lateral wall of the nose over the naso labial fold.  It is curved up to the alar margin.  The classic Moure's incision should not extend into the vestibule of the nose.  The advantage of this incision is that it can be extended above and below to facilitate better exposure of midface, anterior skull base and orbit.  The incision heals with minimal scarring. 

Soft tissue dissection: The dissection is deepened up to the level of bone, the soft tissue is mobilised from the underlying ethmoid bone, antromedial antral wall and nasal pyramid.  This gives excellent access into the nasal cavity.

In the video clipping shown below the rhinolith from inside the nasal cavity is removed via this procedure.  The wound is seen being closed in layers.











Figure showing Moure's lateral rhinotomy incision










Complications:

1. Bleeding from angular vein

2. Wound infection

3. Wound dehiscence

4. Injury to infraorbital nerve / vessels

Video clipping showing lateral rhinotomy being performed