Reply to: "Invited Discussion on: Video Assisted Septo-Rhinoplasty, the Future of Endonasal Rhinoplasty-a Technical Note"

Overview

This is a letter, not a study; it contains no patients or data. Radulesco and colleagues respond to Gryskiewicz and Alameddine's discussion of their technical note on Video Assisted Rhinoseptoplasty (VARS), in which an endoscope is used inside the nose during closed surgery.

Sections of note

• The authors argue technique superiority is context-dependent and VARS addresses concerns about visible scarring.
• They propose comparing closed procedures with and without endoscopic assistance.
• For tip surgery they favour enlarged marginal incisions for direct visual control.
• On the learning curve, they say proficiency is feasible with practice, based on their training experience.
• They accept the need for flexibility, for example spreader grafts where cartilage is weak.

What it means for a patient

• Some surgeons now use a camera inside the nose during closed rhinoplasty to see what open surgery would show, without an external cut.
• This letter is an argument between experts, not evidence of results.

Why this paper matters

It is part of a published exchange on whether endoscopy can extend what closed rhinoplasty can do. Limits: opinion, Level of Evidence V.

Terms

• Endonasal (closed) rhinoplasty: surgery through incisions inside the nostrils.
• Endoscope: a thin camera passed into the nose.
• Marginal incision: an incision along the inner rim of the nostril used to reach the tip cartilages.
• Spreader graft: a cartilage strip placed beside the septum to support the middle vault.