Sarcouncil Journal of Medical Sciences

Abstract: The rhinoplasty procedure is one of the most difficult procedures performed by otolaryngologists, and aesthetics expectations from patients have increased, as they expect not only to benefit from the surgery's airway function, but also from its aesthetic appeal. The purpose of this study was to review the functional and cosmetic outcomes of endoscopic rhinoplasty (ER) techniques in a prospective series of patients who had nasal obstruction and aesthetic deficiencies. This was a cross-sectional study with 115 consecutive patients (68 female and 47 male patients, mean age 32.4 years ± 9.7) who presented from March 2025 to March 2026 for endoscopic-assisted rhinoplasty for combined functional and cosmetic indications at the Department of Otolaryngology, different hospitals in Iraq. All had documented nasal obstruction, which was confirmed by anterior rhinomanometry, and were all requesting cosmetic nasal refinement. Nose Outcome Symptom Evaluation (NOSE) scale, Peak Nasal Inspiratory Flow (PNIF), and Acoustic Rhinometry were used to evaluate functional outcomes at baseline, 6 months, and 12 months post-operatively. The mean NOSE score improved significantly from 72.3 ± 14.6 preoperatively to 21.8 ± 11.2 at 12 months (69.8%). Mean PNIF increased from 84.2 ± 26.3 L/min to 138.7 ± 22.1 L/min. The mean ROE score improved from 31.4 ± 12.8 to 82.6 ± 10.3. 94 patients (81.7%) reached the primary composite outcome of successful functional and aesthetic outcomes. The total complication rate was 11.3% (13/115), and there were no major complications needing urgent intervention. During the follow-up, there was a revision rate of 4.3% (5/115). In patients with both cosmetic complaints and nasal obstruction, endoscopic-assisted rhinoplasty provides excellent functional and cosmetic results. Significant predictors of successful combined outcomes are preoperative nasal obstruction severity, no prior nasal surgery, and younger age