Functional Rhinoplasty

Friedman O, Cekic E, Gunel C.

What this paper says

A review stating that successful breathing surgery depends on examining three structures, the septum and the internal and external nasal valves, and treating whichever is obstructing.

Overview

Functional rhinoplasty aims at the airway rather than appearance. The authors state that understanding nasal anatomy and physiology is the most important requirement. The article identifies the structures that matter for breathing, and frames planning as locating the sites of obstruction or old injury and addressing each during the operation.

Sections of note

Anatomy and physiology are named as the most important points for successful functional rhinoplasty.
The structures playing major roles in nasal breathing are given as the septum and the internal and external nasal valves.
Physical examination of those regions is described as essential.
Planning involves identifying the sites of nasal airway obstruction or old trauma.
Those regions are then addressed during the operation using a number of described techniques.
No specific techniques are named in the abstract, and no patient numbers or outcomes are reported.

What it means for a patient

Blocked breathing usually traces to one of three specific places, not to the nose being generally too small inside.
A physical examination of those areas is what determines the operative plan.
Old nasal injury is a recognized cause and is looked for specifically.
This is a review with no measured results, so it does not report how often functional surgery relieves obstruction.

Why this paper matters

Breathing complaints are common in rhinoplasty patients, and treating the wrong structure is the usual reason surgery fails to help. Naming the three regions gives a checkable examination. The abstract does not evaluate the techniques it refers to.

Terms

Functional rhinoplasty: Nasal surgery aimed at improving breathing.
Septum: The central wall of cartilage and bone dividing the nose.
Internal nasal valve: The narrow angle inside the nose between the septum and the upper lateral cartilage.
External nasal valve: The nostril opening and its surrounding rim, which can collapse inward.
Physiology: How a structure works, as opposed to how it is built.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Understanding nasal anatomy and physiology are the most important points for successful functional rhinoplasty. Anatomic structures playing major roles in nasal breathing functions include the septum, and internal and external nasal valves, so physical examination of these regions is essential. Planning for functional…”

Excerpt; the full abstract is on PubMed.