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Fereydooni S, Green A, Wei EX, Rossi-Meyer MK, Kandathil CK, Most SP. Surgical complications in combined rhinoplasty and endoscopic sinus surgery. Int Forum Allergy Rhinol 2024. [PMID: 38894612 DOI: 10.1002/alr.23388] [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: 01/31/2024] [Revised: 05/04/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
KEY POINTS Complications in combined surgery are equivalent to ESS but are higher than rhinoplasty alone. The most common complications are pneumonia, stroke, and epistaxis. Rhinoplasty surgeries with graft use have a higher risk of complications.
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Affiliation(s)
- Soraya Fereydooni
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Allen Green
- Stanford University School of Medicine, Stanford, California, USA
| | - Eric X Wei
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Monica K Rossi-Meyer
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Cherian K Kandathil
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
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Aydin AC, Karakol P, Sulhan A, Erk H, Bozkurt M. Comparison of Anthropometric and Cephalometric Measurements Obtained by Stereophotogrammetry and 3D Computed Tomography of the Nose Before Septorhinoplasty. Aesthetic Plast Surg 2024:10.1007/s00266-024-04097-9. [PMID: 38755496 DOI: 10.1007/s00266-024-04097-9] [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: 09/15/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Computed tomography (CT) is normally used in evaluation of patients with esthetic and functional nasal deformities. Stereophotogrammetry (SPG) is a measurement device that is an alternative to CT and does not harm human health. In this single-center retrospective study, we aimed to evaluate measurements obtained with CT and SPG. METHODS The measurements of 18 patients who applied to our clinic between January 2022 and August 2022 and planned for septorhinoplasty were performed on both 3D images obtained with paranasal sinus CT and SPG device (SLR type Vectra H1 system). Measurements included that dorsocolumellar length, columella-filtral length, nasal tip projection ratio (dorsocolumellar length/columella-filtral length), columella-labial angle, nasofrontal angle, tip deviation direction, tip deviation angle, tip deviation distance and dorsal nasal hump. RESULTS Most of patients were male (61.1%). Mean age was 24.5 years. Only columella-labial angle measurements showed a low level of significant difference (p < 0.05). However, there was no significance difference in other measurements (p > 0.05). A significant strong correlation was observed between all Vectra and CT measurements (p = 0.000). CONCLUSION SPG device can be applied quickly in polyclinic without giving radiation to patient. Measurements can be taken automatically using a software. Its use in postoperative period does not carry any risk. Disadvantage of SPG is lack of information about internal nasal passage. However, there is a strong correlation between measurements obtained from both measurement devices. Therefore, SPG can be considered as an alternative to CT imaging in operation planning. 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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Affiliation(s)
- Ali Can Aydin
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Percin Karakol
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
| | - Agit Sulhan
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Hamdullah Erk
- Department of Radiology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Mehmet Bozkurt
- Department of Plastic, Reconstructive and Aesthetic Surgery, Health Science University Bagcilar Education and Training Hospital, Istanbul, Turkey
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Bulut OC, Lippert BM, Riedel F, Plath M, Hohenberger R. Quality of Life Improvement in Concurrent Septorhinoplasty and Endoscopic Sinus Surgery. Laryngoscope 2024; 134:1239-1245. [PMID: 37706653 DOI: 10.1002/lary.31054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES Septorhinoplasty (SRPL) and functional endoscopic sinus surgery (FESS) are two frequently performed surgeries to improve quality of life (QoL) in patients with nasal symptoms. It has been demonstrated as a safe combination regarding complication rates, but patient satisfaction in concurrent surgery has not been adequately studied yet. METHODS Patients undergoing sole FESS due to chronic rhinosinusitis (n = 57), sole SRPL (n = 148), and concurrent surgery (n = 62) were prospectively evaluated for their disease-specific QoL before and one year after surgery. Each procedure was performed by the same surgeon (OCB). For SRPL, the patient-reported outcome measures Rhinoplasty Outcomes Evaluation (ROE) and Functional Rhinoplasty Outcome Inventory (FROI-17) were utilized, and for chronic rhinosinusitis, the Sino-Nasal Outcome Test-22 (SNOT22). RESULTS All three groups showed significant improvement in the postoperative QoL measurements (all p < 0.01). The postoperative improvements were slightly smaller in the concurrent surgery group compared with the single surgery groups measured with ROE (combined: +55.2 ± 9.3, single: +58.8 ± 9.8, p = 0.02), FROI total score (combined: +47.6 ± 5.2, single: +49 ± 5.4; p = 0.08) and SNOT22 (combined: +33.1 ± 6.7, single +34.5 ± 7, p = 0.26). CONCLUSIONS SRPL, FESS, and combined surgery improve disease-specific QoL. When applicable, surgeons may offer the benefits of a combined procedure without compromising the QoL gain. LEVEL OF EVIDENCE 3 Laryngoscope, 134:1239-1245, 2024.
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Affiliation(s)
- Olcay Cem Bulut
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
- HNO-Zentrum Rhein-Neckar, Mannheim, Germany
| | - Burkard M Lippert
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | | | - Michaela Plath
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery. Int J Otolaryngol 2020; 2020:5929754. [PMID: 33633795 PMCID: PMC7803282 DOI: 10.1155/2020/5929754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/12/2020] [Accepted: 12/10/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction The endonasal mucosal or anatomic pathologies could lead to poor functional results and dissatisfaction after rhinoplasty. Although computed tomography (CT) scan has become an integral part of the diagnostic paradigm for patients with pathologies of the paranasal sinuses, the use of CT scan for preoperative evaluation of patients seeking rhinoplasty is up for debate. Our aim in this study was to compare the efficacy of CT scan in diagnosing nasal pathologies with other evaluating tools in patients undergoing rhinoplasty. Design In this randomized controlled trial study, 74 consecutive patients seeking cosmetic rhinoplasty referred to otorhinolaryngology clinic were randomly assigned into three groups based on the perioperative evaluation method: the CT group, the nasal endoscopy group, and the control group (anterior rhinoscopy only). Surgical planning was made according to perioperative findings, and the identified endonasal pathologies were corrected during the surgery. The functional and aesthetic outcomes of the rhinoplasty were assessed by Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and the Visual Analogue Scale (VAS) tools before surgery and at 12-month follow-up. Results All outcome measures improved significantly in either group toward one year after rhinoplasty (all with p value <0.05). Subjects in the CT group demonstrated greater improvement in the NOSE, VAS, and ROE compared to other two groups (NOSE: p value = 0.17; VAS: p value = 0.024; ROE: p value = 0.042). Conclusions According to our study, perioperative CT is associated with greater patients' satisfaction and quality of life after rhinoplasty compared to either nasal endoscopy or anterior rhinoscopy. A preoperative CT scan may improve the outcomes of rhinoplasty.
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Hanege FM, Celik S, Gunduz AY, Aksan T. Evaluation of nasal pathologies accompanying rhinoplasty cases at otorhinolaryngology and plastic, reconstructive, & aesthetic surgery clinics. J Plast Reconstr Aesthet Surg 2020; 73:1331-1337. [PMID: 32241735 DOI: 10.1016/j.bjps.2020.02.020] [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: 02/03/2019] [Revised: 12/08/2019] [Accepted: 02/09/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Rhinoplasty is a frequently performed surgical procedure. Besides an aesthetically successful outcome, determination of additional nasal pathologies and making a simultaneous intervention on these are also essential for a successful functional outcome. This study aims to determine the rates of accompanying nasal pathologies in patients undergoing rhinoplasty and reveals whether any additional interventions were performed during operation. MATERIALS AND METHODS In this cross-sectional study, 496 Caucasian Turkish patients who underwent rhinoplasty at the Plastic, Reconstructive & Aesthetic Surgery and Otorhinolaryngology clinics of our research hospital between 2015 and 2018 were retrospectively examined. Among them, the results of 271 patients who had preoperative paranasal computerized tomography scans were evaluated. RESULTS The mean age of the 271 patients was 28.8 years (Range: 17-55). Among them, 156 (57%) were female and 115 (42%) were male. The numbers of patients with septal deviation, inferior concha hypertrophy, unilateral/bilateral concha bullosa, nasal polyp, mucosal thickening, and retention cysts at the Otorhinolaryngology clinic were found to be 126 (82%), 77 (50%), 20 (13%), 10 (6.5%), 77 (50%), and 41 (27%), respectively, and these numbers were respectively 97 (82%), 60 (51%), 11 (9.3%), 2 (1.7%), 57 (48%), and 17 (14%) at the Plastic, Reconstructive & Aesthetic Surgery clinic. A statistically significant difference was found in terms of the presence of retention cysts between the clinics (95% CI -0.11% to 0.16%; P=.014; P<.005), and the presence of retention cysts was significantly higher at the Otorhinolaryngology clinic. A total of 18 (12%) patients were found to have additional surgical interventions. CONCLUSIONS This study showed that additional nasal pathologies were frequently present in patients undergoing rhinoplasty operations. Hence, for a successful operation, it is essential to have Otorhinolaryngology consultation and detect accompanying pathologies in rhinoplasty cases which will be performed by Plastic, Reconstructive & Aesthetic Surgery specialists. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Fatih Mehmet Hanege
- Faculty of Medicine, Department of Otorhinolaryngology, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Serdal Celik
- Faculty of Medicine, Department of Otorhinolaryngology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ayse Yasemin Gunduz
- Faculty of Medicine, Department of Otorhinolaryngology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Tolga Aksan
- Faculty of Medicine, Department of Plastic, Reconstructive & Aesthetic Surgery, Istanbul Medeniyet University, Istanbul, Turkey
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Kochhar A, Zhang Y, Fisher L, Byrne P, Smith SS, Ference EH. Analysis of the operative utilization of concurrent rhinoplasty and endoscopic sinus surgery. Laryngoscope 2019; 130:E311-E319. [PMID: 31077393 DOI: 10.1002/lary.28031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To quantify and analyze the concurrent performance of rhinoplasty (RP) (with or without septoplasty) and functional endoscopic sinus surgery (FESS). STUDY DESIGN Cross-sectional analysis. METHODS Current Procedural Terminology codes were used to extract cases of RP (n = 22,360), FESS (n = 99,173), and concurrent RP with FESS (RP + FESS) (n = 1,321) within the State Ambulatory Surgery Databases of California, Florida, Maryland, and New York from 2009 to 2011. Patient demographics, surgeon volume, charge, concurrent nasal procedures, and operating room (OR) time were compared. RESULTS Among the 1,321 RP + FESS combination cases, a majority involved primary rhinoplasty (n = 697, 52.8%), followed by nasal valve repair (n = 563, 42.6%) and revision rhinoplasty (n = 61, 4.6%). High-volume (n > 30), medium-volume (n = 10-30), and low-volume rhinoplasty surgeons (n ≤ 9) were observed to perform a similar number of FESS + RP combination surgeries (153, 152, and 155, respectively). A majority of RP + FESS involved two or fewer sinuses (65%). Mean OR time for RP + FESS was 189.4 ± 4.2 minutes, approximately 50 minutes shorter than the sum of standalone RP performed individually (138.8 ± 1.0 minutes) and standalone FESS (102.9 ± 0.4 minutes). CONCLUSIONS RP + FESS more frequently involved fewer sinuses (compared with FESS alone) and was also less likely to involve revision rhinoplasty (compared with rhinoplasty alone); therefore, these cases may be selected for lower sinus disease burden and less complex rhinoplasty compared to standalone procedures. Procedures combining rhinoplasty and sinus surgery had a reduction in OR time compared to the hypothetical sum of two standalone procedures. LEVEL OF EVIDENCE NA Laryngoscope, 130:E311-E319, 2020.
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Affiliation(s)
- Amit Kochhar
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, California
| | - Yanchen Zhang
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Laurel Fisher
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, California
| | - Patrick Byrne
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology -Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Stephanie Shintani Smith
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.,Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - Elisabeth H Ference
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, California
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Contemporary considerations in concurrent endoscopic sinus surgery and rhinoplasty. Curr Opin Otolaryngol Head Neck Surg 2018; 26:209-213. [PMID: 29894317 DOI: 10.1097/moo.0000000000000469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. RECENT FINDINGS Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently. Operative time is generally longer for joint surgeries. Patient satisfaction rates are high. SUMMARY Concurrent functional and/or cosmetic rhinoplasty and ESS is a safe endeavor to perform in a single operative setting and most outcomes data suggest excellent patient outcomes. Additional studies that include patient-reported outcome measures are needed.
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Weber RK, Hosemann W. Comprehensive review on endonasal endoscopic sinus surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2015; 14:Doc08. [PMID: 26770282 PMCID: PMC4702057 DOI: 10.3205/cto000123] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.
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Affiliation(s)
- Rainer K. Weber
- Division of Paranasal Sinus and Skull Base Surgery, Traumatology, Department of Otorhinolaryngology, Municipal Hospital of Karlsruhe, Germany
- I-Sinus International Sinus Institute, Karlsruhe, Germany
| | - Werner Hosemann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Greifswald, Germany
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Kim JH, Cho GS, Cheang PP, Jang YJ. The effects of endoscopic sinus surgery on the postoperative outcomes of open rhinoplasty. Ann Otol Rhinol Laryngol 2014; 123:240-6. [PMID: 24671479 DOI: 10.1177/0003489414524172] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Several studies have advocated concurrent endoscopic sinus surgery and rhinoplasty. However, concerns about increased surgical risk, complications, and unsuccessful cosmetic outcomes following the concurrent procedures have been reported. The aim of this study was to investigate the overall safety of concurrent endoscopic sinus surgery and rhinoplasty and to specifically examine the effect of endoscopic sinus surgery on cosmetic outcomes. METHODS We retrospectively reviewed 57 patients who underwent concurrent open rhinoplasty and endoscopic sinus surgery (ESS). We then selected a control group of patients, who underwent rhinoplasty only and were matched with a study group for age, sex, external nose deformity, and implant graft material. The postoperative outcomes of the 2 groups were compared. RESULTS Fifty-seven patients underwent concurrent open rhinoplasty and ESS. Postoperative assessment showed that a successful outcome was achieved in 82.5% of the patients who underwent concurrent procedures and in 87.7% of the patients who underwent rhinoplasty only (P = .56). The rate of revision due to a dissatisfied outcome was 5 patients (8.7%) in the concurrent surgery group and 3 patients (5.3%) in the rhinoplasty-only group (P = .36). Minor complications occurred in 6 patients (10.5%) from the group who underwent the concurrent procedures and 5 patients (8.8%) from the rhinoplasty-only group (P = .76). CONCLUSION Combined rhinoplasty and endoscopic sinus surgery achieves a similar aesthetic outcome to rhinoplasty only, with no significant increase in rates of revision or complication.
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Affiliation(s)
- Ji Heui Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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