Long-term results of functional and cosmetic rhinoplastic surgery.

Three hundred and twelve of 444 patients admitted consecutively for rhinosurgery for nasal obstruction have been examined 5 years postoperatively regarding adequacy of nasal configuration and functional nasal passages. The surgery was introduced with special consideration given as to whether functional and esthetic surgery could be combined without jeopardizing the percentages of patients cured of nasal obstruction. An open nasal passage was found in 233 of the 312 patients at the follow-up examination, while 28 of 65 were relieved of their preoperative nasal deformities. The functional results were independent of whether only reconstruction surgery of the septum and the valve area or additional reshaping of the bony pyramid was performed. These results in the latter group were less satisfactory in males although the cosmetic results were significantly better in the group treated with additional repair of the bony pyramid. A substantial number of patients (26.7%) without saddling of the nose preoperatively had this deformity at the follow-up examination, indicating that training and/or improved surgical approaches were warranted.