DefinePK

Abstract

BACKGROUND: External nasal deformity is often associated with functional nasal obstruction and may coexist with chronic rhinosinusitis (CRS), leading to significant impairment in nasal airflow and quality of life. Functional rhinoplasty, with or without endoscopic sinus surgery (ESS), aims to address both external structural abnormalities and internal sinonasal pathology. However, the outcomes of combined procedures in this population remain underreported in local settings. OBJECTIVE: To evaluate the functional, radiological, and patient-reported outcomes of functional rhinoplasty in patients with external nasal deformity and CRS, and to determine the impact of combining ESS on these outcomes. METHODS: This prospective observational study was conducted at Jinnah Postgraduate Medical Centre (JPMC) and Sir Syed Hospital, Karachi between January 2023 and December 2024, following approval from the Institutional Review Board (IRB). A total of 100 adult patients with external nasal deformity and CRS were enrolled. Patients underwent either functional rhinoplasty alone or combined functional rhinoplasty with ESS. Preoperative and six-month postoperative outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale, anterior rhinomanometry, and Lund-Mackay CT scoring (for those undergoing ESS). Paired t-tests and multivariate regression were applied for statistical analysis. RESULTS: The mean age of patients was 32.6 ± 8.4 years, with 68 (68%) males and 32 (32%) females. Crooked nose was the most frequent deformity (54%). Combined rhinoplasty and ESS were performed in 64 (64%) patients. The mean NOSE score improved significantly from 67.8 ± 10.2 to 21.6 ± 9.1 (p < 0.001). Nasal airflow increased from 290 ± 85 mL/sec to 530 ± 110 mL/sec (p < 0.001). Lund-Mackay scores in the ESS group improved from 12.4 ± 3.6 to 4.2 ± 2.1 (p < 0.001). The complication rate was 8%, with 94% of patients satisfied or very satisfied. CONCLUSION: Functional rhinoplasty, especially when combined with ESS, provides significant functional and radiological benefits with high patient satisfaction and low complication rates.