Outcome-based Comparative Study to Examine the Correction of Columella Deformitiesfollowing Rhinoplasty

The columella is an underrepresented part of rhinoplasty. The objective of this study was to assess the outcome of columella correction following rhinoplasty and to assess any differences in the open and endonasal approach. METHODS: This is a retrospective study involving 65 rhinoplasty patients, who were divided into 2 groups depending on whether they had an open or endonasal approach. Fifteen patients underwent the open procedure, and 50 patients underwent the endonasal approach. Patients who underwent endonasal rhinoplasty were compared with open rhinoplasty patients in terms of their final outcome, with a focus on the columellar correction. The classification by Rohrich and Liu and Gunter’s distance between the nasal axis and columella were used to assess the correction. RESULTS: The overall incidence of columellar correction was 90% in the endonasal group (45 of 50 patients) and 67% in the open approach group (10 of 15 patients); a comparison shows a P value of 0.043 (<0.05). An estimated 49 of 50 patients (98%) from the endonasal group saw a reduction in the nasal axis–columella distance when compared with the open rhinoplasty group, who saw a reduction in 12 of 15 patients (80%); statistical analysis shows a P value of 0.036 (<0.05). The quantitative reduction in this distance in all patients when compared between the 2 groups had a P value of <0.001, suggesting a greater overall reduction using the endonasal approach. This may be related to differences in distribution of the deformities within the 2 groups. CONCLUSIONS: There is no standard way to correct the columella, but it is important to identify the deformity and the need to correct it. In our patients, we found comparable outcomes in achieving a satisfactory columella in the open and endonasal groups.