Functional Role of Scroll Reconstruction in Open Rhinoplasty

Ozturk A, Eroglu S, Batmaz T, İlhan AE, Gode S.

What this paper says

In 28 open rhinoplasty patients split into two groups of 14, rebuilding the scroll area significantly improved measured peak airflow at three months without changing appearance scores.

Overview

The scroll area is where the upper and lower nasal cartilages overlap, and the authors state it matters for breathing. The study tested whether reconstructing it improves the airway after open rhinoplasty. Patients were enrolled in a prospective controlled design and randomly divided into two groups, one with scroll reconstruction and one without.

Sections of note

Prospective controlled study with random allocation; 14 patients per group; the journal assigns level of evidence IV.
The predictor variable was scroll reconstruction, yes or no.
Outcomes were peak nasal inspiratory flow in millilitres per minute and the 10 item SCHNOS survey, measured before surgery and at three months.
There was no demographic difference between the groups.
Scroll reconstruction was associated with significantly improved peak nasal inspiratory flow after surgery, P equals 0.047.
Postoperative SCHNOS breathing and appearance scores did not differ between the groups, P equals 0.58.
The authors state future work should use a larger cohort.

What it means for a patient

Rebuilding the scroll improved an objective airflow measurement taken during forced breathing in.
Patients themselves did not report better breathing on the questionnaire, so the measured gain did not translate into a felt difference.
Appearance results were similar in both groups.
Fourteen patients per group with three month follow up is small and short, as the authors acknowledge.

Why this paper matters

The scroll region sits at the internal nasal valve, the narrowest part of the airway, and open rhinoplasty routinely disrupts it. This trial tests whether restoring it matters. The disagreement between the airflow measurement and the patient questionnaire is the unresolved point.

Terms

Scroll area: where the upper lateral cartilages overlap the lower tip cartilages.
Peak nasal inspiratory flow: the maximum airflow through the nose during a forced sniff, measured with a meter.
SCHNOS: the Standardized Cosmesis and Health Nasal Outcomes Survey, with breathing and appearance sections.
Nasal patency: how open the nasal airway is.
Open rhinoplasty: surgery through an incision across the columella, lifting the nasal skin.

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

From the abstract

“The scroll area of the nose is important for breathing; thereby, its reconstruction can improve the nasal patency. Objective: To evaluate the effect of scroll reconstruction on breathing in patients following open rhinoplasty. Methods: Using the prospective controlled study design, we enrolled a cohort of patients…”

Excerpt; the full abstract is on PubMed.