Abstract

Background
Randomized controlled trials (RCTs) are essential for evaluating surgical interventions, yet adherence to CONSORT reporting guidelines remains inconsistent. Transparent reporting is especially critical in rhinoplasty due to individualized outcomes and diverse surgical techniques. This systematic review assesses adherence to the CONSORT-NPT guidelines in rhinoplasty RCTs and identifies key reporting deficiencies.

Methods
A systematic review following PRISMA and AMSTAR-2 guidelines was conducted. Databases including PubMed, Embase, Cochrane Library, Google Scholar, and MEDLINE were searched for rhinoplasty RCTs published between 2017 and 2024. Adherence to the 25-item CONSORT-NPT checklist was evaluated, and study quality was assessed using the Cochrane Risk of Bias tool and GRADE framework. Descriptive statistics summarized compliance trends, and correlations with journal impact factor and author count were analyzed.

Results
Ninety-seven studies met inclusion criteria, with a mean CONSORT adherence of 68.8%. Objectives (97.9%) and structured abstracts (94.8%) were well reported; however, trial registration (53.6%) and funding disclosures (51.5%) were inconsistently provided. Most trials were single center (94.8%), with limited participants (47.4% of studies enrolled 50 or fewer participants), reducing generalizability. No significant correlations emerged between CONSORT adherence and journal impact factor or author count. Most studies (68.8%) originated from the Middle East. Study quality was generally high or moderate according to GRADE, with predominantly low or moderate risk of bias.

Conclusion
Although CONSORT adherence in rhinoplasty RCTs is moderate, substantial gaps persist in trial registration, funding disclosure, and core methodological reporting. Strengthening enforcement of CONSORT guidelines is the foremost priority for improving research quality. Broader collaboration and geographic inclusion may support external validity but are secondary to rigorous reporting standards. Addressing these deficits will strengthen patient safety, reproducibility, and evidence-based counseling in rhinoplasty.

Level of Evidence I
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