Septoplasty aims to improve nasal function by ameliorating nasal obstruction, but the technique varies depending on the extent of correction. When correcting external nasal deformity in addition to septal deviation, we perform open septorhinoplasty（OSRP）through an external incision. Dissemination of OSRP has been limited because it is difficult to perform and there is no corresponding insurance procedure. However, in 2024, septorhinoplasty was introduced as endoscopic septoplasty type IV by the national insurance system. It is expected to become more widespread in the future. The functional and esthetic aspects of the nose are inseparably linked, as morphological problems almost always coincide; therefore, function and morphology should not be corrected separately. Balanced correction of function and form simultaneously results in greater functional improvements and patient satisfaction. Although it is still challenging for otorhinolaryngologists to master the techniques of plastic surgery, and for plastic surgeons to master the surgical techniques of otorhinolaryngology, I believe that such study is necessary for the development of each department. This paper reports on the current status of OSRP in otorhinolaryngology and the author’s surgical skills as an otolaryngologist.

　　Objective: The Standardized Cosmesis Health Nasal Outcomes Survey（SCHNOS）has been demonstrated as a reliable, valid, and reproducible patient-reported outcome measure（PROM）for simultaneously evaluating nasal symptoms related to both cosmetic and functional aspects. In this study, we assessed subjective outcomes in patients who underwent septorhinoplasty using the Japanese version of SCHNOS（J-SCHNOS）and reviewed the results.
　　Methods: This was designed as a prospective observational study. Subjects who underwent septorhinoplasty for nasal obstruction and/or nasal deformity completed the validated J-SCHNOS questionnaire before surgery and at 3, 6, and 12 months postoperatively. Statistical analysis was performed using a mixed-effects model.
　　Results: The participants were 83 patients（62 men, 21 women; average age: 37.2 years）. J-SCHNOS scores improved significantly at 3, 6, and 12 months after compared with before surgery for both nasal obstruction and cosmetic aspects（p <0.001）.
　　Conclusions: J-SCHOS scores showed significant improvement as early as 3 months postoperatively, with sustained improvements for up to 1 year. The results suggest that J-SCHNOS is a valuable subjective evaluation tool for patients to accurately and easily report information on their nasal problems.

　　Nasal deformity is a difficult condition to treat surgically due to its close associations with nasal airflow obstruction and the possibility of post-operative retroversion. In this study, we propose a novel method to efficiently address high septal deviation, one of the most challenging nasal deformities. Our technique involves the use of a septal swing graft, which requires only a small amount of nasal septal cartilage, and has demonstrated promising outcomes.
　　In the operation, nasal septal cartilage was developed in an open approach, L-strut was set at a 12 mm width, and the nasal septal curvature was excised. The remaining L-strut curvature was corrected by making an incision as far as possible in the dorsal direction of the nose at the nasal septal cartilage-cribriform vertical plate border on the cephalic side of L-strut, and a septal swing graft was inserted into the gap created and fixed. All 11 patients for whom the method was applied from June 2023 and followed for more than six months showed improvement in nasal deformity.
　　The septal swing graft is very useful for the treatment of high septal deviation as it can easily correct L-strut entirely requiring only a small amount of nasal septal cartilage.

　　Treatment options for congenitally missing teeth are controversial, including prosthetic treatment, orthodontic treatment, and long-term observation of remaining deciduous teeth. Long-term observation of remaining deciduous teeth can lead to ankylosis, resulting in infraocclusion, tipping of adjacent teeth, and even maxillary sinus development. When the maxillary sinus develops to the alveolar crest, tooth movement through the maxillary sinus is inevitable, and this can lead to an extended treatment period, root resorption, and tipping tooth movement. The patient was a 14-year-old female with a developed maxillary sinus, hypodontia, supernumerary teeth, an impacted tooth, and transposition of the teeth. Because the patient was young, the ideal treatment goal was to avoid prosthetic treatment. However, because the mandibular left first and second premolars were consecutively absent, we used a setup model to discuss a realistic treatment goal that considers prosthetic treatment in advance. After extraction of the impacted supernumerary tooth, the maxillary first premolars were retracted using a fixed appliance. Bodily tooth movement was achieved by orthodontic tooth movement through the maxillary sinus using a fixed appliance and loop mechanics. Furthermore, all spaces in the congenitally missing teeth were closed, and excellent orthodontic treatment results were achieved without prosthetics.