Question

A nasal surgery was done in this patient and the incision mark is shown. Which of these is probably done?

• A. Septoplasty
• B. Rhinoplasty
• C. FESS
• D. Young's surgery

Hint:

An incision across the columella between the nostrils is the hallmark of one specific nasal operation that reshapes the external nose.

Answer 1

The Correct Option is B

Step 1: Identify the visible landmark. The clinical photograph shows the undersurface (base) of the nose with an incision across the columella (the strip of skin between the two nostrils). This trans-columellar incision, usually a stair-step or inverted-V incision joined to marginal incisions inside each nostril, is the signature of the open (external) rhinoplasty approach.

Step 2: Why Rhinoplasty (Option B) is correct. Open rhinoplasty is performed to reshape the external nasal framework (dorsum, tip, cartilages). To gain wide exposure of the lower lateral cartilages and the nasal tip, the surgeon makes an external incision on the columella and lifts the skin envelope. Hence a visible columellar incision scar points specifically to rhinoplasty.

Step 3: Why the other options are wrong.
• Septoplasty (A) corrects a deviated nasal septum through an endonasal hemitransfixion/Killian incision made on the mucosa inside the nostril - it leaves no external columellar scar.
• FESS (C) - Functional Endoscopic Sinus Surgery is done entirely through the nostrils with an endoscope to clear the sinus ostia; there is no external skin incision at all.
• Young's surgery (D) is closure of the nostrils (used in atrophic rhinitis) by raising skin flaps just inside the nasal vestibule - it does not produce a columellar scar.

Final answer: B (Rhinoplasty).