Comparison of the Effect of Two Low to High Lateral Osteotomy Methods, Percutaneous and Internal On the Tear Trough and Scleral Show in Patients Undergoing Esthetic Open Rhinoplasty.

Background: We aimed to compare the effect of two low to high lateral osteotomy methods, percutaneous and internal on the tear trough and scleral show in patients undergoing esthetic open rhinoplasty.

Methods: This prospective single-blind randomized clinical trial study was conducted on 80 patients in two groups of 40 candidates for rhinoplasty surgery referred to Imam Khomeini Hospital in Ahvaz, southern Iran in 2021. In the first group, lateral osteotomy was performed internally and in the other group, percutaneously. Then, the changes in tear trough and scleral show before surgery, one and three months after surgery were compared between two groups.

Results: The median of the medial limbus in the percutaneous group was about 0.38 higher than the internal group, but no significant difference was observed (P=0.322). Moreover, the median medial canthus in the percutaneous group compared to the internal group had no statistically significant difference (P=0.163). There was no significant difference in the average lateral limbus changes between the two groups (P=0.389). The median scleral show in all times before surgery, one and three months after surgery in the percutaneous group was higher than in the internal group, but the differences were not significant. In addition, the median scleral show changes before and three months after surgery in the percutaneous group were not remarkably different from the internal group (P=0.290).

Conclusion: Both techniques are almost similar in terms of periorbital effect after surgery in the early stages and 3 months after surgery. More multicenter studies with higher sample size and longer follow-up period seem necessary.