Invited Discussion on: Video-Assisted Septo-Rhinoplasty, the Future of Endonasal Rhinoplasty-A Technical Note

Overview

This is an expert discussion, not a study; it contains no patients or data. Gryskiewicz and Alameddine evaluate the technical note by Radulesco and colleagues describing endoscope-assisted septorhinoplasty.

Sections of note

• Acknowledged advantages: improved visibility and easier surgical teaching.
• Concerns: possible restriction in seeing all nasal structures; a steeper learning curve for mastering the endoscope; precision and accuracy problems for sutures and grafts in a small field.
• The discussants stress adapting technique to each patient's anatomy and goals.
• The potential of the method to advance the field is affirmed. Level of Evidence V.

What it means for a patient

• Endoscope-assisted closed rhinoplasty is new and experts disagree about how much it can do.
• The main practical questions are whether the surgeon can see enough and place grafts accurately without an open approach.

Why this paper matters

It records the reservations of established surgeons about an emerging technique, paired with the original note and the authors' reply. Limits: opinion only.

Terms

• Endonasal rhinoplasty: surgery through incisions inside the nose.
• Endoscope: a rigid camera passed into the nasal cavity.
• Learning curve: the number of cases a surgeon needs before achieving consistent results with a new technique.
• Spreader graft: a cartilage strip supporting the middle vault.