Freer's elevator

Freer's elevator was designed by Otto Freer of Illinois Chicago. While he developed this elevator he relied heavily on dental instrument designs. This instrument a fairly simple one will enable the surgeon to elevate mucoperiosteal flap of nasal septum during septoplasty / submucosal resection of nasal septum. This instrument has a dull finish in order to prevent it from unnecessarily reflecting light during the surgical procedure.

It comes in two versions i.e sharp and blunt ones. Sharp one is ideally used to initially elevate the mucoperichondrial flap. After the flap is elevated a little bit the blunt version of the elevator can be used to proceed further. The same instrument has both blunt and sharp edges on either ends. All the surgeon has to do is to reverse the instrument to get the desired effect. It also comes in various lengths.

This elevator is best used to perform dissection at the interface between a hard structure and soft tissue. Freer infact used this instrument to dissect nail out of the nail bed and also to strip periosteum from the bone.

This instrument is also used in urological surgery. Two instruments can be used together to retract soft tissues prior to the resection of renal tumors. This same instrument can also be used to create a soft tissue tunnel beneath the rib.

Otolaryngological uses of Freer elevator:

1. To elevate mucoperichondrial nasal septal flap

2. To medialize middle turbinate during FESS surgeries

3. To strip periosteum from mastoid bone during mastoid surgeries

4. To elevate tympanomeatal flap for harvesting graft

5. For displacement of inferior turbinate in antrostomy

6. For elevating canal skin and cartilage perichondrium in mastoid surgeries

7. To perform uncinectomy

Down the ages this instrument has undergone various modifications. One useful modification being attachment of suction portal which can be connected to a suction apparatus thereby enabling a blood less surgical field.