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Kamburoglu HO, Bitik O, Vargel İ. Airflow Considerations and the Effect of Webster's Triangle in Reduction Rhinoplasty. Aesthetic Plast Surg 2021; 45:2244-2254. [PMID: 33598741 DOI: 10.1007/s00266-021-02168-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/31/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Reduction rhinoplasties, regardless of the methods used (structural or preservation), can cause a reduction in the internal nasal volume, which may lead to breathing problems. In 1977, Webster proposed preserving a little triangle in the beginning of the lower lateral osteotomy line to prevent breathing problem. However, its importance is still controversial. OBJECTIVES and methods: This prospective randomized controlled study (level of evidence 1) included 46 patients without nasal breathing problem. High-to-low (Webster's triangle preservation) osteotomy (control group, n = 23) and low-to-low osteotomy (study group, n = 23) were performed. All operations were performed according to the proposed volumetric rhinoplasty steps (examination/measurement, prevention and treatment). Nasal obstruction symptom evaluation (NOSE) test, visual analog scale, acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow (PNIF), and three-dimensional measurements were performed in all patients. Breathing tests were repeated before and 6 months after surgery with and without xylometazoline administration. RESULTS No statistically significant difference in NOSE and visual analog scale scores was found between the two groups. Acoustic rhinometry, PNIF, and rhinomanometry findings showed no statistically significant breathing difference between the two groups. CONCLUSIONS In reduction rhinoplasties, a decrease in the internal volume may be expected as directly proportional with the reduction amount. The decrease in the internal volume may create nasal breathing problems. To prevent it, nasal airflow should be adjusted according to new anatomy. In this study, we discussed "volumetric rhinoplasty" steps to prevent breathing problems in reduction rhinoplasty. Following these steps, not preserving Webster's triangle (low-to-low osteotomy) has no effect on the nasal airway. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Haldun O Kamburoglu
- Private Practice, Koc Ikiz Kuleleri A Blok No 57 Sogutozu, Cankaya, 06520, Ankara, Turkey.
| | | | - İbrahim Vargel
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Alghonaim Y, Arafat AS, Alobaid F. Postoperative malodorous smell in open septorhinoplasty: the effect of intradomal suturing with mucosal release. Eur Arch Otorhinolaryngol 2020; 278:703-709. [PMID: 32856122 DOI: 10.1007/s00405-020-06307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to test a mucosal release method for decreasing the occurrence of malodourous smells after septorhinoplasty by preventing formation of debris pockets after surgery. METHODS This study included 50 adult patients from 18 to 45 years of age who underwent open septorhinoplasty from January to May 2019. Patients were divided into two groups. The first group had intradomal (transdomal) sutures without submucosal release, while the second group had mucosal release. All patients had scheduled post-op visits at 1, 2, 4, and 8 weeks and 6 months. RESULTS The overall postoperative rate of malodorous smell in both mucosal release and non-mucosal release patients at 2 weeks, 8 weeks and 6 months was 43.1%, 31.4% and 5.9%, respectively. Patients 36-45 years of age had a higher rate of postoperative malodorous smell with 55.6% at 2 weeks, decreasing to 33.3% at 8 weeks, and to less than 1% at 6 months. At 2 weeks after surgery, only 20% of the mucosal release group reported a malodorous smell compared to 65.4% in the non-mucosal release group. The rate was 8% at 8 weeks, and less than 1% at 6 months in the mucosal release group compared to 53.8% at 8 weeks and 11.5% at 6 months in the non-mucosal release group. CONCLUSIONS Utilizing absorbable polydioxanone sutures and releasing the vestibular mucosa of the LLC significantly reduced the rate of postoperative malodorous smell for septorhinoplasty patients with intradomal (transdomal) single-dome suturing.
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Affiliation(s)
- Yazeed Alghonaim
- Division of Otolaryngology Head & Neck Surgery, King Abdullah Specialized Children Hospital (KASCH), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Abdullah S Arafat
- Division of Otolaryngology Head & Neck Surgery, King Abdullah Specialized Children Hospital (KASCH), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.
| | - Fahad Alobaid
- Division of Otolaryngology Head & Neck Surgery, King Abdullah Specialized Children Hospital (KASCH), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia
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Abdelwahab MA, Neves CA, Patel PN, Most SP. Impact of Dorsal Preservation Rhinoplasty Versus Dorsal Hump Resection on the Internal Nasal Valve: a Quantitative Radiological Study. Aesthetic Plast Surg 2020; 44:879-887. [PMID: 32016500 DOI: 10.1007/s00266-020-01627-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND This study evaluates the impact of different hump takedown techniques, namely the conventional hump resection with midvault reconstruction, the push-down (PD) and the let-down (LD) procedures, on the INV dimensions. METHODS In this cadaveric study, six heads were divided randomly into either the conventional hump resection technique (Group A; n = 6 sides) or DPR techniques (n = 6 sides). This latter group was subdivided such that initially a PD procedure was performed (Group B; n = 6 sides), followed by a LD procedure on the same heads (Group C; n = 6 sides). A validated radiological method was used to measure the INV angle and cross-sectional area (CSA) in a modified coronal plane both pre- and post-procedurally. RESULTS Group A did not show significant reduction in the INV angle nor in CSA (p = 0.068 and p = 0.156, respectively). In the push-down group (B), we observed a mean change of 2.05° in the angles and 0.3 cm2 in the CSA (p = 0.0163 and p < 0.001, respectively). The LD group (C) did not show significant reduction in the INV angle nor in CSA (p = 0.437 and p = 0.331, respectively). CONCLUSION Neither the conventional hump resection nor the LD DPR technique reduced the INV dimensions. However, the PD preservation technique significantly reduced the INV dimensions. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Okland TS, Kandathil C, Sanan A, Rudy S, Most SP. Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty. Aesthetic Plast Surg 2020; 44:122-128. [PMID: 31463565 DOI: 10.1007/s00266-019-01484-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cosmetic rhinoplasty has been linked to iatrogenic breathing disturbances using clinical tools. However, few studies have evaluated outcomes using validated, patient-centered instruments. OBJECTIVE We aim to determine the incidence and severity of nasal obstruction following cosmetic rhinoplasty as measured by patient-centered, disease-specific instruments. DESIGN This is a retrospective review of adult patients who underwent cosmetic rhinoplasty at Stanford Hospital between January 2017 and January 2019. General demographic as well as Nasal Obstruction and Symptom Evaluation (NOSE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire data were included. Scores were tracked across postoperative visits and compared to the preoperative state. Patients were subdivided into dorsal hump takedown, correction of the nasal tip, and both. RESULTS Of the 68 included patients, 56 were women, and the mean age was 30.6 years. Although mean SCHNOS and NOSE scores increased at the first postoperative interval, mean scores decreased on each subsequent visit. There were no significant increases in SCHNOS or NOSE scores for either dorsal hump takedown, tip correction, or both. There were only two patients who recorded NOSE scores higher than baseline at most recent postoperative visit. CONCLUSION Our results indicate reductive rhinoplasty is not associated with a greater risk of breathing obstruction when performed with modern airway preservation techniques. The initial increases in obstructive symptoms we observed on the first postoperative visit likely represent perioperative swelling given the improvement on follow-up visits. Both the NOSE and SCHNOS are patient-centered questionnaires capable of evaluating nasal obstruction following cosmetic rhinoplasty. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Gruber RP, Lentz R. Invited Discussion on: Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty. Aesthetic Plast Surg 2020; 44:129-130. [PMID: 31637501 DOI: 10.1007/s00266-019-01508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
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Three-Dimensional Computed Tomography Volume and Physiology of Nasal Cavity After Septhorhinoplasty. J Craniofac Surg 2020; 30:2445-2448. [PMID: 31274820 DOI: 10.1097/scs.0000000000005730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE In this study, the authors aimed to compare the nasal physiology and nasal cavity volume with three-dimensional computed tomography (3D-CT) 1 year after the operation with the values before the operation to investigate the possible narrowing and loss of function in the nasal cavity after septorhinoplasty (SRP) operation. METHODS Of 415 patients who had a primary SRP operation, 28 patients who met the criteria were included in the study. Nasal cavity volumes of patients with postoperative CTs were measured three-dimensionally after a mean 13 months, and objective rhinologic measurements (rhinomanometry, acoustic rhinometry, and peak nasal inspiratory flow [PNIF]) and subjective assessment methods (Visual Analog Scale [VAS], Nasal Obstruction Symptom Evaluation [NOSE]) were performed. RESULTS The mean postoperative VAS and PNIF values of the patients were significantly higher than the mean preoperative values. The mean postoperative NOSE value of the patients was significantly lower than the mean preoperative values. Although the mean MCA-1 and MCA-2 levels of the patients increased postoperatively, the increase was not significant. Although the postoperative mean values of VOL-1 and VOL-2 increased compared with the preoperative values, the increase was not significant. In the CT measurements of the patients, the nasal cavity volumes were significantly higher than the preoperative values. CONCLUSION Nasal cavity volumes in patients undergoing SRP were compared with 3D-CT for the first time in the literature, and a significant increase in nasal volume was observed in the postoperative first year. This finding suggests that the correction of intranasal problems leads to an increase in the nasal volume in SRP operations, although nasal osteotomy is performed.
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Effect of Turbinate Intervention on Nasal Functions in Septorhinoplasty Surgery. J Craniofac Surg 2019; 29:e782-e785. [PMID: 30059420 DOI: 10.1097/scs.0000000000004752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study was performed to evaluate the effect of inferior turbinate reduction on nasal function. MATERIALS AND METHODS A total of 32 patients who underwent septorhinoplasty (SRP) operation were included in the study and assigned into 2 groups as group I who received inferior turbinate reduction during SRP operation consisted of 17 patients and the group II who consisted of 15 patients without inferior turbinate reduction. For 2 groups before and after surgery, visual analogue score and findings of the acoustic rhinometry were recorded both before and after decongestion of the nasal mucosa. RESULTS Postoperative mean visual analogue scale (VAS) scores revealed a statistically significant reduction compared with preoperative values on right and left side of the nasal cavity, both before and after topical decongestion in group I (P < 0.005). Also in group II, the differences of VAS scores for both sides before and after topical decongestion were statistically significant (P < 0.05). Postoperatively, the increase of the volume measurements at the level of pyriform sinüs (VOL2) value on the right side of the nasal cavity before and after decongestion and volume measurements at the level of the nasal valve (VOL1) values on both sides after topical decongestion were found to be statistically significant in group I. When the VAS scores and acoustic rhinometry measurements of group I and group II patients were compared the difference, for before and after topical decongestion, postoperative mean MCA1 (minimal cross-sectional area at the level of the nasal valve) values for left side and right side of nasal cavity were higher in group I than group II and these differences were statistically significant (P < 0.005). CONCLUSIONS As a result, in the SRP operations, turbinoplasty should be implemented by taking into account the function as well as aesthetic concern. Similar results were obtained in other studies that were carried on.
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Litvinov J, Spear WC, Patrikeev I, Motamedi M, Ameredes BT. Noninvasive allergic sinus congestion and resolution assessments using microcomputed tomography imaging. J Appl Physiol (1985) 2018; 125:1563-1575. [PMID: 30161008 DOI: 10.1152/japplphysiol.00980.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sinus congestion resultant of allergic rhinosinusitis is associated with development and worsening of asthma and can result in difficulty breathing, headaches, and missed days of school and work. Quantification of sinus congestion is important in the understanding of allergic rhinosinusitis and the development of new drugs for its treatment. Noninvasive microcomputed tomography (micro-CT) was investigated in a guinea pig model of allergic rhinosinusitis to determine its utility to determine accurately the degree of sinus congestion and resolution with anti-inflammatory drug administration. Three-dimensional sinus air-space volume, two-dimensional sinus width, sinus image air-space area, and sinus image sinus perimeter were measured in guinea pigs administered ragweed pollen (RWP), intranasally (i.n.), followed by administration of fluticasone, i.n. To determine their relative accuracy in assessing sinus congestion, the micro-CT image results were compared with the "gold-standard" method of sinus fluid fill-volume (SFFV) measurements. As measured by SFFV method, RWP increased sinus congestion in a RWP concentration-dependent fashion, approaching near-total sinus blockage with concentrations ≥22 µg of RWP. At this level of congestion, fluticasone (25-100 µg) progressively decreased sinus congestion in a concentration-dependent fashion. The noninvasive micro-CT methods were found to accurately determine the amount of sinus congestion and resolution, with patterns of increases and decreases of congestion that were nearly identical to the SFFV method. We conclude that noninvasive micro-CT measurements of allergic sinus congestion can be useful as an investigative tool in the assessment of congestion intensity and the development of new drug therapies for its treatment. NEW & NOTEWORTHY Allergic rhinosinusitis afflicts significant portions of the world population, resulting in loss of work productivity and decreased quality of life. Thus the development of methodological approaches, which incorporate accurate and reproducible noninvasive assessments of sinus congestion, are desirable. Microcomputed tomography of the guinea pig sinuses offers a noninvasive evaluation tool in an animal model of IgE-dependent allergy similar to that in humans, with potential relevance toward development of therapeutics for human sinus diseases.
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Affiliation(s)
- Julia Litvinov
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch , Galveston, Texas
| | - Walter C Spear
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch , Galveston, Texas
| | - Igor Patrikeev
- Center for Biomedical Engineering, University of Texas Medical Branch , Galveston, Texas
| | - Massoud Motamedi
- Center for Biomedical Engineering, University of Texas Medical Branch , Galveston, Texas
| | - Bill T Ameredes
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch , Galveston, Texas
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Pecorari G, Riva G, Bianchi FA, Cavallo G, Revello F, Bironzo M, Verzè L, Garzaro M, Ramieri G. The effect of closed septorhinoplasty on nasal functions and on external and internal nasal valves: A prospective study. Am J Rhinol Allergy 2018; 31:323-327. [PMID: 28859710 DOI: 10.2500/ajra.2017.31.4459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Because nasal function and shape are so closely intertwined, quantitative assessments can better define their relationship and how they are affected by septorhinoplasty. OBJECTIVE The aim of this prospective study was to perform an analysis of the nasal airflow resistances and a three-dimensional (3D) evaluation of the soft-tissue changes after closed septorhinoplasty. METHODS Before surgery (T0) and 6 months after closed septorhinoplasty (T1), 30 patients underwent symptoms evaluation by means of the Italian version of the Nasal Obstruction Symptom Evaluation scale, endoscopic fiberoptic nasal examination, and visual analog scale for subjective assessment of nasal obstruction. Nasal airflow resistances were investigated with active anterior active rhinomanometry. A 3D laser scanner was used to evaluate facial soft-tissues, with specific nasal points and angles. RESULTS Subjective nasal obstruction decreased. Anterior active rhinomanometry demonstrated a reduction in total inspiratory and expiratory resistances between T0 and T1 but without statistical significance. The significance was still absent after decongestion, excluding turbinate hypertrophy as a cause of failed objective amelioration of nasal resistance. Facial laser scanning showed statistically significant reduction of the superior nasal width and superior alar angle, and a weak negative correlation between the superior alar angle and nasal resistances. CONCLUSION The absence of objective reduction of nasal airflow resistances could be the result of concurrent surgery on nasal septum and nasal valve. In particular, the ameliorating effect on nasal airflow resistances is counterbalanced by the worsening effect of the narrowing of nasal valve.
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Affiliation(s)
- Giancarlo Pecorari
- Otorhinolaryngology Division, Surgical Sciences Department, University of Turin, Turin, Italy
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Comparison of Clinical Results in Nasal Tip Augmentation Either Via Face to Face or Back to Back Technique With Autogenous Auricular Conchal Cartilage. J Craniofac Surg 2016; 26:2109-14. [PMID: 26468792 DOI: 10.1097/scs.0000000000002079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To compare the objective and subjective findings between patients who underwent nasal tip augmentation surgery via two different methods using autogenous auricular conchal cartilage. MATERIALS AND METHODS This study included the data of 21 patients who underwent nasal tip augmentation surgery. The patients were randomly divided in two groups according to the technique used to form a double layer columellar strut graft; either face to face (group 1) and back to back (group 2). All patients were assessed via nasal obstruction symptom evaluation scale (NOSE) and via acoustic rhinometry and rhinomanometry at preoperative and postoperative 1st and 6th months. RESULTS There was statistically significant improvement in symptom score in both patient groups with no difference inbetween. Total nasal resistance decreased nonsignificantly at the end of 6th month in both groups; 13.1 Pa/cm3 to 8.6 Pa/cm3 and 10.3 Pa/cm3 to 9.5 Pa/cm3 respectively. There was no significant increment in MCA values for both groups except left MCA1. CONCLUSIONS We achieved good results in tip augmentation via both techniques. An autogenous conchal cartilage is a good alternative to replace lacking caudal septal cartilage. It provides safe and stable support to the nasal tip. However, further comprehensive studies with larger sample size and long follow-up are required to elucidate any difference between these two techniques.
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Difficult septal deviation cases: open or closed technique? Braz J Otorhinolaryngol 2016; 83:256-260. [PMID: 27210822 PMCID: PMC9444782 DOI: 10.1016/j.bjorl.2016.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/11/2016] [Accepted: 03/18/2016] [Indexed: 11/20/2022] Open
Abstract
Introduction The aim of this study is to compare the functional aspects of open technique (OTS) and endonasal septoplasty (ENS) in “difficult septal deviation cases”. Methods 60 patients with severe nasal obstruction from S-shaped deformities, multiple deformities, high deviations etc. were included in the study. The OTS was used in 30 patients and the ENS was performed in 30 patients. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered preoperatively and at first month following surgery. Patients were also evaluated for pain postoperatively with Visual Analog Scale (VAS). Results The mean NOSE score was decreased 62.5–11.0 in the OTS group and 61.3–21.33 in the ENS group. Improvement of the symptoms following the two surgical techniques is similar and no statistically significant difference was found between both techniques. Also there was no statistically significant difference in postoperative pain between the OTS and ENS groups evaluated by VAS. Conclusion ENS is as successful as the OTS in management difficult septal deviation cases. In patients with severe septal deformities type of the surgical technique should be selected according to the surgeon's experience and the patient's preference.
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Effects of Spreader Grafts on Olfactory Function in Septorhinoplasty. Aesthetic Plast Surg 2016; 40:106-13. [PMID: 26698162 DOI: 10.1007/s00266-015-0597-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 11/13/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Following rhinoplasty, the cross-sectional parts of the nose may be significantly reduced, and nasal air movement and olfaction may be altered. Studies on olfactory function after surgical procedures are quite limited and have largely focused on sinus surgery or septoplasty. OBJECTIVES The objective of this study is to assess the consequences of spreader grafts on olfactory function. METHODS This prospective study was conducted at the Gaziosmanpaşa Taksim Education and Research Hospital, Department of Otolaryngology, from January 2014 to June 2015. In total, 68 patients who had undergone an open-technique septorhinoplasty were included. In 35 patients, bilateral spreader grafts were included with the open septorhinoplasty (group 1), and 33 patients underwent open septorhinoplasties without spreader grafts (group 2). RESULTS The age and gender distributions of the patients in the two groups did not differ (p > 0.05). Preoperative threshold, discrimination, and identification values in both groups did not differ (p > 0.05). In groups 1 and 2, postoperative threshold values were significantly higher than preoperative values (p < 0.05). The change in threshold, discrimination, and identification level was significantly higher postoperatively versus preoperatively in group 1 (p < 0.05); however, the changes in discrimination and identification values did not significantly differ between in group 2 (p > 0.05). CONCLUSIONS Our study demonstrates the superior widening effect of spreader grafts over the nasal valve and favorable results in olfactory function in primary septorhinoplasty patients. LEVEL OF EVIDENCE IV This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Comparison of surgical outcomes and patient satisfaction after 2 different rhinoplasty techniques. J Craniofac Surg 2015; 25:1284-6. [PMID: 24911600 DOI: 10.1097/scs.0000000000000587] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Various methods of surgical treatment are defined in nasal deformities that cause nasal obstruction. Open technique septorhinoplasty is a method that is frequently used for this purpose. This study aims to compare surgical results of open technique septorhinoplasty operations with and without osteotomies. In addition, changes in the quality of life of patients before and after treatment were investigated, and the effects of the 2 methods on patients' quality of life were compared. METHODS Patients with nasal deformity were included in the study. Forty patients with wide nasal dorsum and a prominent hump underwent septorhinoplasty with lateral osteotomy (group 1), and 35 patients with a narrow nasal dorsum and a minimal hump underwent septorhinoplasty without osteotomy (group 2). A Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate disease-specific quality of life for patients in both groups. Basic characteristics, operative parameters, and preoperative and postoperative NOSE scores were compared between the groups. RESULTS Demographic properties of the groups were similar. Intraoperative parameters and postoperative complications were not different between the groups, with the exception of operation time (which was significantly longer in group 1) and ecchymosis (which was seen in whole cases of group 1 and none of the group 2). Preoperative NOSE scores were similar in both groups. Postoperative NOSE scores were 5 (0-45) in group 1 and 10 (0-45) in group 2 (P > 0.05). The NOSE scores were significantly decreased after the operation in both groups (P < 0.001). The 2 groups were not significantly different when comparing the change in preoperative and postoperative NOSE scores. CONCLUSIONS Rhinoplasty with or without osteotomy is an effective treatment for alleviating nasal obstruction symptoms. Osteotomy is an integral but not obligatory part of the operation. The addition of the osteotomy procedure in selected cases prolonged the operation time and significantly enhanced patient satisfaction.
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Celebi S, Caglar E, Yilmaz B, Develioglu O, Topak M, Is H, Kulekci M. Does rhinoplasty reduce nasal patency? Ann Otol Rhinol Laryngol 2014; 123:701-4. [PMID: 24789802 DOI: 10.1177/0003489414532783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of rhinoplasty on subjective and objective assessment of nasal patency in patients who underwent rhinoplasty for cosmetic reasons only. SETTING Tertiary referral center. DESIGN Prospective, clinical study. SUBJECT AND METHODS A total of 50 adult patients who underwent rhinoplasty were included in the study. Preoperative and postoperative photographs of the nasal profile (frontal, lateral, and oblique) were obtained. The visual analog scale (VAS) was used for the subjective evaluation of nasal obstruction (0 being the minimum, 10 being the maximum amount of nasal patency). Objective evaluation of nasal obstruction was performed with a peak nasal inspiratory flowmeter (PNIF). RESULTS Preoperative mean VAS scores and PNIF values of the patients were 7.36 ± 0.83 and 115.10 ± 17.45, respectively. Postoperative mean VAS scores and PNIF values of the patients were 7.42 ± 0.73 and 115.30 ± 16.7, respectively. There was no statistically significant difference between any of the pre- and postoperative subjective and objective parameters (P > .05). CONCLUSION Reduction rhinoplasty has been shown not to reduce nasal patency.
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Affiliation(s)
- Saban Celebi
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Erdem Caglar
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Baki Yilmaz
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Omer Develioglu
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Murat Topak
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Halim Is
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Kulekci
- Department of Otorhinolaryngology-Head and Neck Surgery, Taksim Education and Research Hospital, Istanbul, Turkey
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Edizer DT, Erisir F, Alimoglu Y, Gokce S. Nasal obstruction following septorhinoplasty: how well does acoustic rhinometry work? Eur Arch Otorhinolaryngol 2012; 270:609-13. [PMID: 22777215 DOI: 10.1007/s00405-012-2102-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 06/21/2012] [Indexed: 11/28/2022]
Abstract
Septorhinoplasty aims to improve not only the esthetic appearance but also breathing function of the nose. Although the esthetic improvement can be judged by the patient and the surgeon easily, evaluation of nasal breathing is more complicated. Besides the subjective symptom scores given by the patient, some objective methods have been developed. One of the most widely used of these objective methods is acoustic rhinometry, which gives valuable information about the cross-sectional areas and volumes of the nasal airway as a function of distance from the nostril. Since the introduction of acoustic rhinometry, many papers were reported regarding its efficiency with some conflicting conclusions. Septorhinoplasty has the potential to narrow the nasal airway, especially if it includes lateral osteotomies and hump reduction. We aimed to evaluate the role of rhinoplasty on nasal obstruction with the help of subjective symptom scores and acoustic rhinometry. The study consisted of 26 patients who underwent septorhinoplasty. Before and after surgery, the symptom scores and findings of acoustic rhinometry were collected both before and after decongestion of the nasal mucosa. Symptom scores decreased on both sides, which were statistically significant (p < 0.05), however, the changes in cross-sectional areas of the nasal airway were not statistically significant (p > 0.05). The correlation between the symptom scores and acoustic rhinometry findings was not significant for all levels. The effect of septorhinoplasty on nasal airway and some important maneuvers to protect against nasal obstruction are discussed.
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Affiliation(s)
- Deniz Tuna Edizer
- Department of Otolaryngology, Bayrampasa State Hospital, Atakoy 4. Kisim O119 D:6, Bakirkoy, Istanbul, Turkey.
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