Background:Nasal septum deviation (NSD) is a common structural anomaly leading to impaired nasal airflow and associated complications. Traditional septoplasty techniques often face challenges in maintaining structural stability, especially in complex cases. This study compares the efficacy of extracorporeal septoplasty using polydioxanone (PDO) plates versus conventional septoplasty techniques for managing complex NSD. Objective:To evaluate and compare postoperative outcomes, including nasal patency, structural stability, and complication rates, between the two techniques. Methods:A prospective, comparative study was conducted with 100 patients divided into two groups: Group A underwent extracorporeal septoplasty with PDO plates, and Group B underwent conventional septoplasty. Pre- and postoperative assessments included the visual analog scale (VAS), nasal obstruction symptom evaluation (NOSE) score, endoscopic evaluation, and radiological imaging. Follow-ups were conducted at 1, 3, and 6 months. Results:Group A showed significant improvements in nasal patency and NOSE scores compared to Group B (P < 0.05). Structural stability was superior in Group A, with fewer complications such as septal perforation and recurrence. Patient satisfaction was markedly higher in the PDO plate group. Conclusion:Extracorporeal septoplasty with PDO plates demonstrated better postoperative outcomes and fewer complications than conventional techniques, making it a superior option for managing complex NSD.