Comparison on functional and esthetic outcomes between single and combined surgery to crooked nose deformities

Background: Nose deviation deformities pose a complex cosmetic and functional problem. The most common surgical intervention to manage such deformities is septorhinoplasty, typically performed by a plastic surgeon or a rhinologist. This study investigated the effect of a combined operation by a plastic surgeon and rhinologist, comparing them with those operations performed singlehandedly by a plastic surgeon.

Methods: From January 2017 to January 2022, 99 patients with deviated noses were treated. Fifty-nine underwent the combined operation, whereas 40 underwent surgery performed by a plastic surgeon. In the combined operation group, the rhinologist performed endonasal septoplasty and turbinoplasty, while the plastic surgeon performed open rhinoplasty, osteotomies, caudal septal deviation correction, camouflage procedure, esthetic enhancement, and dorsal augmentation. Subsequently, the rhinologist checked the airway and applied a nasal tamponade. Treatment outcomes were evaluated using the Rhinoplasty Health Inventory and Nasal Outcomes (RHINO) questionnaire and incidence of postoperative complications.

Results: Of the 79 patients who responded to the RHINO questionnaire, 33 underwent an operation by a plastic surgeon, whereas 46 underwent the combined operation. All cases showed improved scores on the RHINO questionnaire postoperatively, with significantly higher scores in the combined group (p = 0.032). Furthermore, the combined group showed more significant improvements in function-related questions, despite longer total operation durations. The overall complication rate was 10.1%.

Conclusion: A combined surgical correction for deviated nose by a plastic surgeon and rhinologist could provide better subjective outcomes, especially in functional outcomes.