Electromyographic and electroneurographic changes in internal nasal muscles after endonasal and external rhinoplasty

Overview

Rhinoplasty lifts, cuts and stitches the tissues over the nasal skeleton, including small muscles that move the nostrils and tip. The authors measured muscle and nerve function with surface electrodes before and after surgery to see whether the open approach, with its columellar incision and wider dissection, harms these muscles more than the closed approach.

Sections of note

• 48 patients; surface electromyography and electroneurography recorded before and after rhinoplasty.
• Patients grouped by open (external) or closed (endonasal) approach.
• Electroneurography amplitudes decreased after surgery on both sides in both groups (p < .001).
• Electromyography showed a significant drop in contraction amplitude for all voluntary movements in 2 patients in the closed group (6.6%) and 2 in the open group (11.1%).
• The difference between groups was not significant (p = .280).
• The abstract does not state when the postoperative measurements were taken.

What it means for a patient

• Both open and closed rhinoplasty reduced measured nerve signal to the nasal muscles.
• A small number of patients in each group showed clearly weaker muscle activity afterward.
• Choosing open over closed did not, in this study, mean more muscle damage.
• The abstract does not say whether the changes were noticeable to patients or whether they recovered over time.

Why this paper matters

Muscle injury is a rarely measured effect of rhinoplasty. This study gives objective electrical evidence that both approaches affect the nasal muscles to a similar degree. Recovery over time and any effect on nostril movement or breathing remain unanswered.

Terms

• Electromyography (EMG): recording the electrical activity of a muscle when it contracts.
• Electroneurography (ENG): recording the electrical signal carried by a nerve to a muscle.
• Open (external) rhinoplasty: approach through a small cut across the columella, lifting the skin off the tip.
• Closed (endonasal) rhinoplasty: approach through incisions hidden inside the nostrils.
• Amplitude: the size of the recorded electrical signal.
• Columella: the strip of skin between the nostrils.