“Closed” Rhinoplasty: an Out-of-Date Procedure?

“Closed” Rhinoplasty: an Out-of-Date Procedure?
Luca D’Ascanio*

Abstract: The approach used by the founding fathers of rhinoplasty has incorrectly been called “closed” rhinoplasty, since the term “closed” suggests that the surgeon cannot see or access vital areas of the nose during surgery. The term “endonasal” more accurately describes this particular approach. However, with the advent of “open” or “external” septorhinoplasty in the late ‘70s, the former “endonasal” techniques were progressively abandoned. “Open” rhinoplasty is the most commonly taught approach to residents in Otolaryngology, Plastic Surgery and Maxillo-Facial Surgery in western countries thanks to its advantages in terms of surgical exposure and consequent teaching/learning easiness. Furthermore, most medical literature now a days focuses on “open” procedure, thus making “closed” rhinoplasty appear an out-of-date approach not worthy to be learnt and developed. We describe the principles of “endonasal” rhinoplasty with respect to “open” approach, together with the present and potential future of such technique.