What Really Works in Functional Rhinoplasty?

by Jeffrey Mella, MD, Samuel Oyer, MD, and Stephen Park, MD •

TRIO Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.

BACKGROUND

Nasal airway obstruction is one of the most common complaints presenting to an otolaryngologist and may dramatically impact a patient’s quality of life. Among possible etiologies of nasal airway obstruction are anatomic deformities of the external framework of the nose resulting in lateral wall or nasal valve dysfunction.

Functional rhinoplasty is an umbrella term used to describe the various surgical techniques that alter the external nasal structure with the goal of improving nasal breathing. Most experts agree that functional rhinoplasty is most successful when tailor-made to address the patient’s specific anatomic deformities. Thus, it is advantageous for the surgeon to have a wide range of techniques in their armamentarium.

Throughout the evolution of functional rhinoplasty, numerous techniques have been described and shown to be successful. Controversy exists regarding which techniques are most effective to address various deformities. The goal of this article is to review the available literature to examine, which surgical techniques within functional rhinoplasty are most successful in treating nasal airway obstruction.

BEST PRACTICE

Based on the available data, it is not currently possible to draw conclusions about the superiority of a single graft or technique in functional rhinoplasty. Data suggest that most, if not all, appear to be highly effective. Although difficult to design, future studies directly comparing techniques, randomized and with a control group, controlling for the effect of concomitant septoturbinoplasty, and using validated and standardized outcome measures, will shed light on this topic and improve surgical decision-making.