Endoscopic-assisted versus conventional closed septorhinoplasty: a comparative study of functional, aesthetic, and postoperative outcomes.

Abstract

Background: Nasal septal deviation is a common cause of nasal obstruction, and septorhinoplasty addresses both functional and aesthetic concerns. The role of endoscopic assistance in closed septorhinoplasty remains incompletely characterized.

Objectives: To compare conventional closed and endoscopic-assisted septorhinoplasty regarding functional and aesthetic outcomes, postoperative morbidity, and operative time.

Materials and methods: This prospective, randomized, single-blinded clinical trial included 50 patients randomized to conventional closed (group A) or endoscopic-assisted septorhinoplasty (group B). Outcomes included Nasal Obstruction Symptom Evaluation (NOSE) scores, FACE-Q Rhinoplasty Module, operative time, and postoperative morbidity (edema, ecchymosis, pain).

Results: Operative time was longer in group B (116.68 ± 7.02 vs. 90.96 ± 7.07 min; p < 0.001). Group B showed significantly greater NOSE score improvement at 1 and 6 months (p < 0.001). Aesthetic satisfaction was higher in group B at 1 month (p < 0.001) but comparable at 6 months. Postoperative edema, ecchymosis, and day-7 pain scores were significantly lower in group B (p < 0.05).

Conclusions and significance: Endoscopic-assisted septorhinoplasty offers superior early functional outcomes and reduced postoperative morbidity despite longer operative time, with comparable long-term aesthetic results. These findings support endoscopic assistance as a valuable adjunct for enhancing surgical precision and early recovery in septorhinoplasty.