Sensory Changes in Nasal Subunits Following Open and Closed Rhinoplasty: A Randomized Controlled Trial

Skin sensation changes are common after rhinoplasty and can be troublesome for patients postoperatively. The closed technique may be considered as causing less sensory loss compared to the open technique due to its conservative approach, minimal dissection and low tissue damage potential. A randomized study was planned to compare the sensory changes in the subunits of the nasal skin caused by the two main methods using objective and subjective parameters.

In the analysis of the patients, the nose was divided into seven subunits: nasion, rhinion, nasal tip, left alar wing, right alar wing, infratip lobule and columella base. Evaluations were done preoperatively and at the first, third, sixth and twelfth months postoperatively. Objective sensory evaluations were done using the Semmes-Weinstein monofilament test. The subjective sensory changes of each nasal unit were subjectively evaluated by the patients on a three-point Likert scale.

Both objective and subjective evaluations showed a statistically significant decrease in sensation in the nasal tip and infratip lobule in the open group one month after surgery. In the closed group, no significant differences were observed between the preoperative and postoperative sensory values for nasal subunits across all periods.

While a decrease in sensation was observed in the tip and infratip lobule in the open technique by the first month postoperatively, this loss of sensation returned to a normal level by the third month. In the closed technique, however, no significant loss of sensation was detected in the postoperative period. In light of our findings, surgeons can have a better insight into postoperative sensory changes in the subunits of nasal skin which makes them more confident and reassuring when there are concerns regarding altered sensation after rhinoplasty. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .