Comparative Evaluation of Open Versus Closed Rhinoplasty Techniques: A Prospective Clinical Study of Functional and Aesthetic Outcomes.

Introduction Rhinoplasty is a widely used procedure aimed at correcting nasal deformities to improve both function and aesthetics. The open and closed techniques are two main surgical approaches, each with specific indications and advantages. This study aimed to compare clinical, functional, and aesthetic outcomes between open and closed rhinoplasty. Methods A prospective study was conducted in the Department of Otorhinolaryngology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, from August 2013 to December 2015. A total of 30 patients with primary external nasal deformities were included, of whom 15 underwent open rhinoplasty and 15 underwent closed rhinoplasty. Pre- and postoperative assessments included photographic analysis of aesthetic angles (nasofrontal, nasofacial, and nasolabial) and the Nasal Obstruction Symptom Evaluation (NOSE) score. Follow-up ranged from 7 to 12 months (mean: 9.5 months). Results Of the 30 patients, 17 (56.7%) were male and 13 (43.3%) were female. Post-traumatic deformity was the most common etiology (n = 12; 40%), followed by developmental (n = 10; 33.3%) and congenital causes (n = 7; 23.3%). A total of 21 patients (70%) presented with both cosmetic and functional complaints. Higher aesthetic satisfaction was observed in the open group (12 of 15 patients; 80%) compared to the closed group (9 of 15; 60%). Functional improvement, reflected by reduced NOSE scores, was noted in both groups. Postoperative complications were more frequent in the closed group, including persistent deviation (n = 4; 26.7%) and nasal obstruction (n = 3; 20%). Conclusion Both techniques were effective, but open rhinoplasty provided improved aesthetic outcomes and fewer complications, particularly in complex deformities.