[The relationship between the post-rhinoplastic functional disorders, the surgical approach and techniques, the magnitude and extent of the intervention].

The objective of the present study was to investigate the functional consequences of aesthetic rhinoplasty. The authors compared the results of corrective surgery depending on the surgical approach, the extent of the intervention, and the operative techniques employed based on large enough set of clinical observations obtained during the treatment of 253 patients. It was shown that the post-rhinoplastic difficulties in nasal breathing experienced by some patients occurred significantly more frequently after the use of the «endonasal» surgical approach than following «open» rhinoplasty (75% vs 68%). The functional outcome of the intervention was much better in the case of single-step rhinoseptoplasty than after the intranasal intervention (turbinoplasty, sinusotomy) based on the results of objective assessment (the total volumetric flow (TVF) 629±98 cub. cm/s and 397±65 cub. cm/s respectively; p<0.05). It is concluded that the application of the structure-sparing tools during primary rhinoplasty, such as expandable grafts, extending flaps, and restorative transplants, can reduce the severity and the frequency of the functional disorders likely to develop during the long-term follow-up (TVF 550±85 cub. cm/s vs 303±50 cub. cm/s; p<0.05).