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COMPARE THE ADVANTAGE AND DISADVANTAGE OF CLOSE AND OPEN RHINOPLASTY

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The following table shows a comparisons between close and open rhinoplasty:

PARAMETERCLOSE RHINOPLASTYOPEN RHINOPLASTY
VisualizationLimited: most aspect of surgery is a blind procedureExcellent: an exposure is extensive which allows:
-Binocular vision
-Use of both hands
-Good control of bleeding
-Precise placement and surturing of struts, batten and shield graft.
-Useful in teaching
Visibility of scar (columella)The incision is endonasal so not visibleThe incision involved result in scar across the columella
Surgical time and exposure to anaesthetic agentsLessMore
Post operative swelling and healingBetter circulation to skin of nasal tip and no disruption of natural drainage of columella and skin so there is less swelling and heals fasterIncision in columella disrupts the circulation of skin so there is more swelling and healing is slow.
Ability to sculpt the noseModerate- so only useful for minor deformityExcellent- so recommended for following:
- Cleft tip nose
-Revision surgery
-Severe nasal trauma
-Elaborated reduction, augmentation procedure
-Marked tip deformity
- The need for extra tip rotation
- Correction of external over projection
-situation where assessment of exact pathology is difficult.
- Extended aplication:
*Nasal septal perforation repair
*Nasal dermoid removal
* Approach to hypophysectomy

incision on open and close rhinoplasty

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