Rate and Severity of Nasal Mucosal Tear in Internal and External Lateral Nasal Osteotomy

There is an ongoing debate on the appropriateness of internal or external osteotomy in rhinoplasty. This study aimed to compare these two techniques in terms of nasal mucosal tear. In this study, 30 candidates for elective nasal surgery were studied in a 12-month period. Each patient underwent an external lateral osteotomy performed on one side and an internal lateral osteotomy performed on the other side by a trained specialist. In a blinded manner, another investigator performed the nasal endoscopy to detect the nasal mucosal tears and the results was reported them in millimeter (mm). A total of 30 patients, 10 males and 20 females with the mean age of 26.47±7.36 years (20-30) were enrolled in this study. Nasal mucosal tear was reported in all patients with internal lateral osteotomy, whereas this rate was 90% in the other group (p= 0.24, odds ratio=1.11, 95% confidence interval=0.99-1.25). The median length of the mucosal tears was 9 mm in the cases with internal osteotomy vs. 4 mm in the patients with external approach. The difference was statistically significant (p<0.001). The data analysis stratified by the patients’ age and sex revealed a significant association neither with frequency nor with severity of the nasal mucosal tears. This study showed that internal osteotomy, as compared with external technique, is accompanied with significantly more severe nasal mucosal damage in patients undergoing elective nasal surgery.