Comparative Efficacy of Endoscopic Endonasal versus Transcranial Approaches for Treating Olfactory Groove Meningiomas: A Systematic Review and Meta-Analysis.

Technique of performing an epidural blood patch in spontaneous intracranial hypotension due to cerebrospinal fluid leakage from the nerve root sheath: Case series.

In the past, the primary method for repairing cerebrospinal leaks was through craniotomy with intradural repair. However, in recent times, the popularity of transnasal repair via endoscopic sinus surgery has increased. This shift is mainly due to its lower morbidity and higher success rates. Nevertheless, the rise in iatrogenic CSF leaks has occurred as more surgeons adopt endoscopic sinus surgery. Therefore, caution must be exercised by endoscopic sinus surgeons when utilizing this technique. The objective of our study is to present a novel approach to endoscopic repair of CSF leaks. Herein, we present and discuss a case involving a 55-year-old woman with idiopathic CSF rhinorrhea accompanied by meningoencephalocele. Our technique involved the introduction of a specifically secured vicryl sutured fat plug into the intradural space, followed by applying traction on the suture to effectively seal the defect. This mechanism operates similarly to how a bath plug seals a bathtub. Importantly, our patient did not experience any intra- or post-operative complications. Furthermore, we did not utilize a lumbar drain or intra-thecal fluoresce in during the procedure.

Spontaneous spinal CSF leaks: a rare variant exome sequencing study and functional analysis.

Genetic underpinnings of spontaneous spinal CSF leaks.

Spontaneous spinal cerebrospinal fluid (sCSF) leaks represent a significant source of morbidity, presenting with symptoms of spontaneous intracranial hypotension. Type 1a leaks are classified as ventral dural tears, with thoracic defects proving to be especially challenging to diagnose and treat. Epidural blood patches remain first-line for many cases; however, their efficacy is variable. Traditional surgical management of sCSF leaks typically involves open laminectomy with transdural direct suture repair, with attendant risks due to wide laminectomy and spinal cord exposure/manipulation. This study demonstrates that endoscopic extradural repair technique is a reliable minimally invasive alternative for treating type 1a sCSF leaks. A transforaminal endoscopic extradural approach with subsequent onlay patch repair technique was performed on 11 patients with spontaneous type 1a CSF leaks at spinal levels ranging from T2-3 to L1-2. All patients were from a single institution from 2024 to 2025. Data on clinical outcomes, perioperative variables, and risk factors for reoperation were collected. Eleven patients (8 female:3 male) underwent endoscopic repair with DuraGen, TachoSil, and TISSEEL with adjunctive lumbar drain placement for CSF diversion. 81.8% of patients experienced resolution of their symptoms and returned to normal daily activities within 3 months. The mean estimated blood loss was 11.1 mL, operative time averaged 170 minutes, and average length of stay was 6.8 days due to preplanned CSF diversion. Two patients underwent reoperation for recurrent/persistent leak, without satisfactory resolution of symptoms after reoperation. One incidence of a small nonoperative pneumothorax occurred. In this study, a single-surgeon cohort of 11 patients underwent transforaminal endoscopic extradural repair of type 1a sCSF leaks. The results suggest that transforaminal endoscopic extradural approach with onlay patch repair is a safe and effective alternative to existing surgical techniques for type 1a CSF leaks. Additional studies are warranted for further characterization, direct comparison with traditional techniques, and long-term outcome assessment.

Inadvertent dural injury during lumbar spine surgery is a common complication with reported incidence up to 21%. When inadequately repaired or unrecognized, this can lead to cerebrospinal fluid (CSF) leak and orthostatic headache. Current management strategies include conservative treatment, surgical dural repair, or subarachnoid drain placement. The purpose of this study was to evaluate the technical feasibility and early clinical outcomes of CT-guided epidural blood patch (EBP) as a minimally invasive option for symptomatic postoperative CSF leaks. A retrospective analysis was performed on patients who underwent decompressive lumbar laminectomy at a single academic medical center with subsequent clinical symptoms of CSF leak treated with CT-guided EBP. All patients underwent postoperative lumbar MRI. EBP outcomes were assessed at the immediate periprocedural period, short-term follow-up (≤ 90 days), and long-term follow-up (> 90 days) when available. Nine patients met inclusion criteria and underwent CT-guided EBP. All nine patients (100%) achieved immediate symptomatic relief of positional headaches. Eight of nine patients (88.9%) reported sustained complete resolution at short-term follow-up. One patient had partial improvement only but developed recurrent symptoms 16 days later, ultimately requiring surgical repair. Long-term follow-up data was available for 6 patients, all of whom maintained sustained symptom resolution (median 812 days, range 141-1471 days). No procedural complications were observed. CT-guided EBP demonstrated promising clinical outcomes for the treatment of symptomatic postoperative lumbar CSF leaks in this small retrospective series. This minimally invasive technique represents a potential treatment option for selected patients, complementing existing surgical and conservative approaches.

Bacterial meningitis is a rare but serious complication following neurosurgical procedures. Acinetobacter baumannii (A. baumannii) has emerged as an opportunistic pathogen, causing serious infections worldwide. The increasing prevalence of multidrug-resistant strains presents growing challenge in healthcare settings. The occurrence of multidrug-resistant A. baumannii meningitis after Posterior Lumbar Interbody Fusion (PLIF) surgery is exceptionally uncommon. We report a 59-year-old osteoporotic female who developed A. baumannii meningitis resistant to our available antibiotics following PLIF for L5/S1 spondylolisthesis. Although a minor durotomy occurred during surgery due to sever adhesion in the inflamed tissue and no cerebrospinal fluid (CSF) leakage was observed postoperatively. The patient experienced fever and headache on first day after discharge which was managed with ondansetron, and then gradual loss of consciousness six days after discharge occurred, leading to her readmission. Despite administration of intravenous antibiotics and two courses of intrathecal antibiotic therapy via an External Ventricular Drain (EVD), her condition progressively deteriorated, and she ultimately succumbed to the infection. This case highlights the critical importance of maintaining dura integrity and adhering to strict operating room sterilization protocols. As resistant organisms become increasingly prevalent, healthcare providers must exercise heightened vigilance in the early recognition and management of infections following neurosurgical procedures.

To evaluate the value of three-dimensional visualization preoperative planning based on the open-source software 3D Slicer in endoscopic endonasal optic nerve decompression for traumatic optic neuropathy. A prospective randomized controlled study was conducted. A total of 48 patients with traumatic optic neuropathy who underwent endoscopic endonasal optic nerve decompression at the Affiliated Eye Hospital of Nanchang University between January 2023 and June 2025 were enrolled and randomly assigned to an experimental group (3D Slicer-based three-dimensional visualization planning, n = 25) and a control group (conventional two-dimensional CT planning, n = 23). The primary outcome measures included operative time, intraoperative misjudgment rate, complication rate, surgeon's subjective score (5-point Likert scale), and visual improvement at 3 months postoperatively. Continuous data were analyzed using independent-sample t-test or Mann-Whitney U test, and categorical data were analyzed using Fisher's exact test. There were no statistically significant differences in baseline characteristics or preoperative visual acuity grade between the two groups (P > 0.05). The operative time was significantly shorter in the experimental group than in the control group (129.4 ± 11.6min vs. 150.7 ± 20.4min, P < 0.001). Postoperative visual acuity improved significantly compared with preoperative values in both groups (experimental group: P < 0.001; control group: P = 0.003), but the intergroup difference in the grade of visual improvement was not statistically significant (P = 0.439). The intraoperative misjudgment rate was 0% (0/25) in the experimental group and 13.0% (3/23) in the control group, with no statistically significant difference (P = 0.24). The incidence of cerebrospinal fluid leakage was 4.0% (1/25) in the experimental group and 21.7% (5/23) in the control group, and the difference did not reach statistical significance (P = 0.08). The surgeon's subjective score was significantly higher in the experimental group than in the control group [5 (5,5) vs. 4 (4,4), P < 0.001]. No severe complications such as major vessel injury or direct optic nerve injury occurred in either group. Three-dimensional visualization preoperative planning based on 3D Slicer can significantly shorten the operative time of endoscopic endonasal optic nerve decompression, enhance the surgeon's confidence, and a potential reduction in cerebrospinal fluid leakage that warrants further investigation. This approach is low-cost, highly generalizable, and has good clinical application value.

Visual impairment due to optic chiasm compression is a frequent complication of pituitary macroadenomas and substantially impacts quality of life. Reported postoperative visual field (VF) results after endoscopic endonasal transsphenoidal surgery (EETS) vary across series. We performed a single-arm meta-analysis to quantify postoperative VF outcomes after EETS for pituitary macroadenomas. PubMed/MEDLINE, Scopus, and Web of Science were searched in accordance with PRISMA through September 2025. Eligible studies were prospective or retrospective clinical series of pituitary macroadenomas (≥ 5 patients) undergoing EETS with extractable postoperative VF outcomes. Pooled proportions for VF improvement, normalization, stability, deterioration, and cerebrospinal fluid (CSF) leak were calculated using random-effects models with Freeman-Tukey double-arcsine transformation. Heterogeneity was assessed using I2 and prediction intervals were reported. Twenty nine studies involving 2,943 patients met criteria. Across studies, the combined rate of postoperative VF improvement was 79% (95% CI: 73-84%), while normalization was achieved in 41% (95% CI: 29-53%). VFs remained unchanged in 19% (95% CI: 14-25%) of patients, and deterioration following surgery was infrequent (1%; 95% CI: 0-1%). The pooled postoperative CSF leak rate was 7% (95% CI: 4-10%). In pooled single-arm data, EETS for pituitary macroadenomas is associated with high rates of VF improvement and rare postoperative deterioration. Because VF testing and follow-up were heterogeneous across studies, these pooled results should be interpreted as benchmark outcome rates rather than standardized recovery "patterns." Standardized VF reporting is needed to enable stronger prognostic and time-course analyses.

The diagnosis of spinal CSF leak rests on tests that are individually imperfect and still evolving. A normal brain MRI does not exclude a leak, spine MRI cannot detect CSF-venous fistulas, and advanced myelography is technique dependent. As a result, a negative study often reflects the limits of the method or its sensitivity rather than the true absence of disease, yet it is frequently communicated to patients and referring clinicians as a definitive answer. A 'classic' orthostatic headache, long treated as the entry criterion for spontaneous intracranial hypotension (SIH), captures only part of the disease and may be least reliable in patients with CSF-venous fistulas. These gaps contribute to well-documented diagnostic delays. This article considers how the neuroradiologist's role might extend beyond the signed report to address them. This State of Practice synthesizes current evidence on brain and spinal MRI, dynamic myelographic technique, empiric patching, and the patient diagnostic experience, together with the perspective of a neuroradiology practice subspecialized in spinal CSF leak imaging and treatment. For selected patients with suspected SIH, the neuroradiologist's role should extend beyond issuing a report. These include patients whose phenotype and imaging disagree, who remain symptomatic despite a "negative" study, or who face escalating procedural choices. In such cases the neuroradiologist is often best positioned to turn imaging uncertainty into a decision through a focused, patient-facing consultation: reconciling phenotype with imaging, auditing whether prior testing matched the suspected leak type, directing the next best step, and weighing the cost of each option with the patient. Its value should be measured against the patient's entire diagnostic odyssey, not a single imaging report. A negative study lowers the probability of a leak; it does not reduce it to zero. Better care may require neuroradiologists to step out of the reading room.

Craniopharyngiomas confined to the third ventricle present formidable surgical challenges owing to their deep location and proximity to critical neurovascular structures. This study evaluates the transcavernous sinus transtuber cinereum (TCSTC) approach, a technically advanced route that enables direct access to the third ventricle while preserving surrounding anatomy. Ten cadaveric heads were meticulously prepared with vascular injections, and the right side was dissected under magnification using a surgical microscope. High-resolution imaging and digital caliper measurements were used to define a safe entry zone through the tuber cinereum. The anatomic window was delineated between the mammillary bodies and pituitary stalk insertion. In the clinical setting, 5 patients with pure intraventricular craniopharyngiomas were treated using a pretemporal craniotomy combined with a partial medial transcavernous approach. The surgical outcomes and postoperative complications were reviewed. Cadaveric dissections confirmed that the TCSTC approach provides a consistent and safe anatomic corridor to the third ventricle, with a mean safe entry width of 8.2 mm (range 7.15-8.85 mm). This approach facilitates optimal visualization of the interpeduncular fossa, mammillary bodies, and basilar tip perforators. In all 5 clinical cases, gross total resection was achieved without any intraoperative complications. Postoperative outcomes included transient diabetes insipidus in 2 patients and long-term hormone replacement therapy in 3 patients. No cerebrospinal fluid leaks, infections, or recurrences were observed at the latest follow-up. The TCSTC approach is a safe and effective strategy for resection of pure intraventricular craniopharyngiomas. It offers enhanced anatomic visualization while minimizing hypothalamic and vascular injuries. With appropriate technical execution, maximal tumor removal with low morbidity is possible. Further validation using larger series and long-term follow-up is warranted.

Inner ear malformations can cause abnormal communication between the inner ear and subarachnoid space, leading to otogenic cerebrospinal fluid (CSF) leakage and subsequent bacterial meningitis. Persistent leakage may result in recurrent meningitis, which is associated with neurological sequelae and poor prognosis; thus, early diagnosis and surgical intervention are essential. Various surgical strategies have been reported, commonly termed middle ear obliteration and inner ear obliteration. However, their definitions remain ambiguous, and techniques vary widely in approach and effectiveness. This study describes 2 pediatric cases of incomplete partition type I (IP-I) malformation complicated by recurrent meningitis that were treated with translabyrinthine fistula closure via the lateral semicircular canal, a form of inner ear obliteration. Both patients exhibited high vestibular CSF pressure due to hypoplasia of the internal auditory canal fundus. Patient 1 had undergone 4 previous window closure surgeries elsewhere without success, whereas Patient 2 had no residual hearing and required prompt management. In both cases, the fistula was directly identified and sealed with a three-layer construct under direct visualization, allowing secure closure. Postoperative follow-up revealed no recurrence of meningitis for >8 years in Case 1 and more than 1 year in Case 2, without complications. This technique may represent a reasonable treatment option for controlling CSF leakage in severe inner ear malformations, including cases refractory to conventional treatments, even at the cost of sacrificing inner ear function. Using 2 representative pediatric cases, this study presents a case-based review that clarifies the classification, indications, and limitations of current surgical strategies for otogenic CSF leakage associated with inner ear malformations.

To compare the clinical efficacy between total en bloc spondylectomy (TES) and separation surgery combined with stereotactic body radiotherapy (SSRS) in patients with isolated spinal metastases secondary to NSCLC. A total of 85 NSCLC patients diagnosed with isolated spinal metastases were enrolled in this retrospective analysis. All patients received treatment between June 2018 and April 2022, among whom 25 patients underwent TES and the remaining 60 patients were managed with SSRS. Evaluated endpoints included local tumor control, PFS, OS, postoperative complications, and quality of life assessed via the SOSGOQ scale. TES yielded superior local tumor control and significantly prolonged PFS relative to SSRS. Nevertheless, the TES group presented larger intraoperative blood loss and a higher postoperative complication incidence. Specifically, cerebrospinal fluid leakage occurred in 20% of TES patients and pleural rupture in 12%, whereas both complications only accounted for 3.3% in the SSRS cohort. No significant intergroup difference was observed in OS. TES provides superior local tumor control and extended PFS for NSCLC patients with isolated spinal metastases, accompanied by increased intraoperative blood loss and higher complication risks. OS remains comparable between the two therapeutic modalities. Both approaches effectively improve patients' postoperative quality of life. These outcomes highlight the necessity of multidisciplinary collaborative decision-making to individualize and optimize therapeutic strategies for this clinical population.

Anterior cervical discectomy and fusion (ACDF) is an important treatment for cervical degenerative diseases and trauma. Cerebrospinal fluid (CSF) leakage caused by intraoperative dural injury is a rare but clinically significant complication. The current mainstay approach involves dural repair using patches and fibrin glue. The bone wax sealing method is a novel technique for managing intraoperative CSF leakage during ACDF. This study aims to analyse the effectiveness of bone wax sealing in treating intraoperative CSF leakage. A retrospective analysis was conducted on consecutive patients who underwent ACDF and were identified as having intraoperative CSF leakage between January 2020 and October 2025. Patients were divided into two groups according to the primary method used to manage the leak: the patch repair group and the bone wax sealing group. In the patch repair group, a dural patch was applied over the dural tear and secured with fibrin glue. In the bone wax sealing group, bone wax was used to completely occlude the anterior interbody space around the interbody cage, thereby physically isolating the prevertebral space from the intervertebral space. Clinical outcomes were assess between the two groups. Among 1,311 ACDF patients, 23 cases (1.75%) experienced intraoperative cerebrospinal fluid (CSF) leakage resulting from iatrogenic dural tear. The maximum diameter of all tears was ≤ 5mm. Twelve cases were managed with dural patch repair (using dural substitute and fibrin glue), and 11 with bone wax sealing. In the dural patch group, 10 cases achieved successful repair, while 2 required additional lumbar drainage due to persistent leakage. No failures were observed in the bone wax group, and no case developed other postoperative complications. In two groups, no safety-related comorbidities were identified. The cost of the patch and adhesive was ¥3,953, whereas the bone wax costed only ¥18, indicating a significant difference. The bone wax sealing method is easy to operate, simple, and highly cost-effective. In appropriately selected cases (small dural tears and complete hemostasis), it may be considered a viable alternative to dural patch repair.

Extracapsular resection is effective for functioning pituitary adenomas, but its role in tumors with suprasellar extension remains unclear. The aim of this study was to evaluate surgical outcomes of a refined endoscopic transnasal technique for nonfunctioning pituitary adenomas with suprasellar extension, focusing on pseudocapsule-based extracapsular resection. We retrospectively analyzed 259 patients with tumors ≥20 mm and ≥1-year follow-up (2007-2023). Factors associated with complete pseudocapsular resection and surgical outcomes were evaluated using unadjusted and multivariable logistic regression analyses stratified by surgical period. A pseudocapsule was identified in 52.5% of cases, and complete resection was achieved in 34.4%. Total resection was achieved in 73.7%, with most residual tumors in the cavernous sinus. Complete pseudocapsular resection was associated with smaller tumor size, reduced intraoperative cerebrospinal fluid leakage, lower residual tumor rates, and fewer postoperative hemorrhages and complications in unadjusted analyses.In multivariable analyses, these associations were significant in the early period but not in the later period, whereas reduced overall complications remained significant across both periods. Tumor regrowth occurred in 22 patients and was controlled with stereotactic radiotherapy. Tumor size-but not suprasellar extension-was associated with complete pseudocapsular resection. Complete pseudocapsular resection is associated with improved outcomes, particularly during earlier phases of surgical experience, although its relative impact may decrease with increasing surgical proficiency. Careful identification and resection of the pseudocapsule should be pursued when feasible.

Cerebrospinal fluid (CSF) leak after retrosigmoid vestibular schwannoma resection remains a challenging complication. Historically, surgeons reopened the prior retrosigmoid incision for transmastoid repair because the safety of creating a separate postauricular incision was uncertain, with concerns regarding wound breakdown and infection. However, limited data support this practice, and a focused mastoid incision may offer improved access and patient tolerance. This study evaluated wound healing outcomes following transmastoid repair using a new postauricular incision for persistent CSF leak after retrosigmoid surgery in patients without serviceable hearing. We retrospectively reviewed 27 patients who underwent transmastoid repair for persistent postoperative CSF leak after retrosigmoid craniotomy for vestibular schwannoma (2000-2025). Demographics, operative details, timing of leak diagnosis and repair, wound complications, readmissions, antibiotic use, and culture results were analyzed. Median age was 48 years (IQR 41-56); 67% were male, and mean BMI was 29.0 kg/m2. Mastoid obliteration was performed in 96%, with fat grafting in 93%. A new postauricular incision was used in all cases. Median time to leak diagnosis was 13 days (IQR 4-79), and median time to repair was 2 days (IQR 1-5). One patient (3.7%) developed a superficial wound abscess; no dehiscence or flap necrosis occurred. At median follow-up of 34 months (IQR 2.9-87.7), all wounds were healed. CSF leak recurred in two patients (7.4%) and three (11.1%) required reoperation. A separate postauricular incision for transmastoid CSF leak repair was not associated with increased wound morbidity. Durable wound healing was achieved in all patients, with 93% legal control, supporting this anatomy-driven approach.

To investigate the feasibility and effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via a single incision for the treatment of adjacent two-segmental lumbar disc herniation (LDH). A retrospective analysis was performed on 33 adjacent two-segmental LDH patients treated with single-incision UNSES between June 2023 and May 2025, including 18 males and 15 females, with a mean age of 55.7 years (range, 28-74 years) and a mean disease duration of 11.2 months (range, 3-36 months). There were 4 cases of L 3, 4, L 4, 5 herniation and 29 cases of L 4, 5 and L 5, S 1 herniation. Pfirrmann grade of disc degeneration was grade 3 in 24 segments, grade 4 in 39 segments, and grade 5 in 3 segments. Perioperative indicators were recorded. The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were evaluated preoperatively and at 3 days, 3 and 6 months postoperatively. The modified MacNab criteria were used to assess patient satisfaction at last follow-up. Postoperative lumbar CT or MRI was applied to evaluate nerve root decompression. Lumbar lordosis angle and L 3, 4, L 4, 5, and L 5, S 1 segmental endplate angles on standing lateral X-ray films were measured to compare sagittal balance changes before operation and at last follow-up. The operation time was 70-126 minutes, with an average of 84.8 minutes; the incision length was 1.8-2.4 cm, with an average of 2.1 cm; the fluoroscopy frequency was 1-4 times, with an average of 2.2 times; and the hospital stay was 5-12 days, with an average of 7.6 days. All patients were followed up 6-24 months, with an average of 14.1 months. The incidence of complications was 6.1% (2/33), including 1 case of dural tear (<4 mm) required no suture and presented no cerebrospinal fluid leakage, and 1 case complete inferior articular process resection had no obvious low back pain during follow-up. No myeloid hypertension-like syndrome, nerve root injury, cerebrospinal fluid leakage, or intervertebral space infection occurred in other patients. VAS score of low back and leg pain and ODI at each time point after operation were lower than those before operation, and further decreased with time, and the differences between different time points were significant ( P<0.05). According to the modified MacNab criteria, 19 cases were excellent, 10 cases were good, 4 cases were fair, and the excellent and good rate was 87.9%. Postoperative lumbar MRI showed that the herniated nucleus pulposus tissue had been removed in all patients, the cross-sectional area of the spinal canal was significantly increased, and the nerve root was not significantly compressed. At last follow-up, there was no significant difference in lumbar lordosis angle, L 3, 4 endplate angle, L 4, 5 endplate angle, and L 5, S 1 endplate angle when compared with those before operation ( P>0.05). Single-incision UNSES has the advantages of small trauma, high safety, flexible operation, and extensive decompression, which can effectively complete the removal of two adjacent segments herniated disc, and the effectiveness is satisfactory.

Horan and colleagues recently reported a pilot study examining quality-of-life outcomes following early versus late elective lumbar microdiscectomy, concluding that surgery within twelve months is associated with superior patient-reported outcomes and proposing a six-month maximum waiting time. While the clinical question is both relevant and timely, we believe several methodological and conceptual issues merit discussion before such a recommendation is translated into practice. First, the study conflates waitlist time with symptom duration, yet its Discussion and proposed threshold are predominantly grounded in literature examining the latter. Second, only 38 of 64 eligible patients (59%) were included in the analysis, with no characterisation of non-responders, and the postoperative assessment window varied from ten to thirty-four months, introducing substantial noise into between-group comparisons. Third, the absence of preoperative baseline scores precludes calculation of minimal clinically important differences and leaves the authors’ conclusions vulnerable to baseline imbalance. Fourth, the authors’ own data reveal a cost and complication paradox: the early group experienced a longer length of stay, a higher median cost, and a ten per cent cerebrospinal-fluid leak rate versus zero per cent in the late group—findings that directly oppose the cost-consequence literature invoked in support of their thesis. Finally, the study period coincided with the COVID-19 pandemic, which substantially altered surgical throughput and perioperative pathways across Europe; this temporal confounding is neither acknowledged nor adjusted for. A robust answer to this important question will require a prospective design with capture of symptom duration, preoperative and standardised-interval postoperative outcome measures, an a priori sample-size calculation, formal characterisation of non-responders, and adjustment for era-related confounders.

Rhinoplasty is one of the most frequently performed aesthetic surgical procedures worldwide. Awareness of potential postoperative complications may differ between adolescents and adults and may influence expectations regarding surgery. The objective of this study was to compare baseline awareness of well-established rhinoplasty-related complications between adolescents and adults recruited from a general otorhinolaryngology outpatient setting. This cross-sectional survey included 372 participants (196 adolescents and 176 adults). The questionnaire assessed demographic characteristics, attitudes toward rhinoplasty, and awareness of specific rhinoplasty-related complications. Participants were stratified into adolescent and adult groups, and intergroup comparisons were performed using chi-square analysis, with statistical significance set at P < .05. Significant differences were observed between adolescents and adults in awareness of multiple rhinoplasty-related complications. Adults demonstrated significantly greater awareness of several intraoperative complications, including cautery burns (P = .023), collapse of the bony pyramid (P = .006), osteotomy-related complications (P < .001), and perinasal trauma (P < .001). No significant intergroup differences were identified for immediate postoperative complications. In contrast, pronounced differences were observed in early and late postoperative complications. Adults showed significantly higher awareness of septal hematoma (P< .001), wound dehiscence (P< .001), persistent edema (P = .007), cerebrospinal fluid rhinorrhea (P = .004), polybeak deformity (P < .001), synechiae formation (P < .001), septal perforation (P = .011), nasal valve collapse (P < .001), and patient dissatisfaction (P = .031). Baseline awareness of rhinoplasty-related complications differs significantly between adolescents and adults, with adults demonstrating greater knowledge across multiple complication domains.