Fareya Usmani, Syed Mosaddaque Iqbal, Mukhtar Ibrahimi, Syed Iqbal Hussain, Sohail Tirmizi, Imran Munir, Aftab Imtiaz.
Open Approach Rhinoplasty for Correction of Nasal Deformities in Tertiary Care Hospital.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;25(2):82-9.

Objective: To study reasons for open rhinoplasty procedure and evaluate complications and outcomes. Methods: This prospective Cohort study was conducted from Sept. 2012 - Oct. 2019 at Department of ENT/Head & Neck Surgery, Sir Syed Medical College and Jamal Noor Hospital Karachi after ethical approval. Total 49 patients included by consecutive sampling. Adult patients (>18 years, both genders)presenting with functional and aesthetic nasal issues were included that underwent open approach rhinoplasty. Patients who underwent rhinoplasty earlier, with residual deformity, with cleft lip or palate and who lost follow up before a year were excluded. Demographic details, indications for surgery and clinical findings documented on specially designed proforma. Photograph record obtained preoperatively, third post-operative day, three monthly till one year. Results: amongst 49 cases (15 males & 34 females), between 22-31 years age. Most common rea-sons were grossly deviated nose 58%, saddle nose 23%, dorsal hump 17% and crooked nose 7%. Most cases had nasal tip deformities (i.e. under projected, rotation or asymmetry). Complications observed were septal hematoma (2 cases), poly beak deformity, nasal valve stenosis and periorbital edema on each patient. Mean time for nasal packing was 12 hours, and hospital stay was 24 hours. One patient required revision surgery for poly beak deformity and one for nasal valve stenosis. External scar (columellar) were invisible after few months in all cases. Conclusion: Open rhinoplasty is the preferred, safe and effective procedure with promising results. This approach allows accurate anatomical detail of nasal framework (osteo-cartilaginous vault). Further options are available to deal with original tissues and graft materials as well as suture stabilization of grafts with ease and additional benefits. Satisfactory results with minimal side effects are reasons for preferable use of this procedure.

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