Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis

Background:. Despite advancements in techniques, the choice between open and closed rhinoplasty remains contentious. This decision is influenced by patient-specific factors, deformity complexity, and surgeon expertise, with outcomes often tied to functional and aesthetic results. Methods:. A systema...

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Main Authors: Christophe Abi Zeid Daou, MD, Rita Maria Jalkh, MD, Zeina Maria Semaan, MD, Anne Marie Daou, MD
Format: Article
Language:English
Published: Wolters Kluwer 2025-08-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007047
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author Christophe Abi Zeid Daou, MD
Rita Maria Jalkh, MD
Zeina Maria Semaan, MD
Anne Marie Daou, MD
author_facet Christophe Abi Zeid Daou, MD
Rita Maria Jalkh, MD
Zeina Maria Semaan, MD
Anne Marie Daou, MD
author_sort Christophe Abi Zeid Daou, MD
collection DOAJ
description Background:. Despite advancements in techniques, the choice between open and closed rhinoplasty remains contentious. This decision is influenced by patient-specific factors, deformity complexity, and surgeon expertise, with outcomes often tied to functional and aesthetic results. Methods:. A systematic literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases searched included Medline, PubMed, Embase, and Cochrane. Abstracts and full-text articles were screened, and reference lists from relevant articles were reviewed to identify additional studies. Two investigators independently performed the review. Studies comparing open and closed rhinoplasty techniques, encompassing randomized controlled trials, prospective studies, and retrospective studies, were included. The target population comprised adults (≥18 y) undergoing rhinoplasty. Key parameters analyzed were changes in Rhinoplasty Outcome Evaluation (ROE) score, Nasal Obstruction Symptom Evaluation (NOSE) score, edema, ecchymosis, complications, and operative time. Results:. Twenty studies were included, with 12 providing data for meta-analysis (1067 patients: 539 open rhinoplasty and 528 closed rhinoplasty). Study quality was moderate, with limitations such as the absence of sample size calculations and biased endpoint assessments. No significant differences were identified between the approaches in ROE scores (standardized mean difference = −0.16), NOSE scores (standardized mean difference = 0.21), edema, ecchymosis, operative time, satisfaction, or complication rates. Heterogeneity was observed in the ROE (I² = 99%) and NOSE (I² = 86%) analyses, reflecting technique and patient variability. Conclusions:. Open and closed rhinoplasty techniques show similar efficacy. The choice should be tailored to patient needs and surgeon expertise. Continued innovation and standardized research are essential to optimize outcomes.
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spelling doaj-art-e8b8d383081d48ea918c7382c4728e372025-08-26T03:24:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-08-01138e704710.1097/GOX.0000000000007047202508000-00035Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysisChristophe Abi Zeid Daou, MD0Rita Maria Jalkh, MD1Zeina Maria Semaan, MD2Anne Marie Daou, MD3From the Department of Otolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.From the Department of Otolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.From the Department of Otolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.From the Department of Otolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.Background:. Despite advancements in techniques, the choice between open and closed rhinoplasty remains contentious. This decision is influenced by patient-specific factors, deformity complexity, and surgeon expertise, with outcomes often tied to functional and aesthetic results. Methods:. A systematic literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases searched included Medline, PubMed, Embase, and Cochrane. Abstracts and full-text articles were screened, and reference lists from relevant articles were reviewed to identify additional studies. Two investigators independently performed the review. Studies comparing open and closed rhinoplasty techniques, encompassing randomized controlled trials, prospective studies, and retrospective studies, were included. The target population comprised adults (≥18 y) undergoing rhinoplasty. Key parameters analyzed were changes in Rhinoplasty Outcome Evaluation (ROE) score, Nasal Obstruction Symptom Evaluation (NOSE) score, edema, ecchymosis, complications, and operative time. Results:. Twenty studies were included, with 12 providing data for meta-analysis (1067 patients: 539 open rhinoplasty and 528 closed rhinoplasty). Study quality was moderate, with limitations such as the absence of sample size calculations and biased endpoint assessments. No significant differences were identified between the approaches in ROE scores (standardized mean difference = −0.16), NOSE scores (standardized mean difference = 0.21), edema, ecchymosis, operative time, satisfaction, or complication rates. Heterogeneity was observed in the ROE (I² = 99%) and NOSE (I² = 86%) analyses, reflecting technique and patient variability. Conclusions:. Open and closed rhinoplasty techniques show similar efficacy. The choice should be tailored to patient needs and surgeon expertise. Continued innovation and standardized research are essential to optimize outcomes.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007047
spellingShingle Christophe Abi Zeid Daou, MD
Rita Maria Jalkh, MD
Zeina Maria Semaan, MD
Anne Marie Daou, MD
Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
Plastic and Reconstructive Surgery, Global Open
title Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
title_full Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
title_fullStr Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
title_full_unstemmed Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
title_short Outcomes of Open Versus Closed Rhinoplasty, a Systematic Review and Meta-analysis
title_sort outcomes of open versus closed rhinoplasty a systematic review and meta analysis
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007047
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