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Khan M, Mortada H, AlRajhi B, Alwagdani A, Almosa W, Almolhim K, Obeid AA, Neel OF. Role of External Nasal Splinting Following Rhinoplasty: Is It Really Important? A Comprehensive Systematic Review of Literature. Aesthetic Plast Surg 2023; 47:2642-2650. [PMID: 36964289 DOI: 10.1007/s00266-023-03317-y] [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: 12/01/2022] [Accepted: 03/01/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Following rhinoplasty, external nasal splints are used to reshape the cartilage and reposition the nasal bone. Despite the popularity of using an external nasal splint in rhinoplasty procedures, there is still a lack of evidence of the effectiveness of using the external nasal splint post-rhinoplasty. This systematic literature review aimed to evaluate the evidence regarding the use of external nasal splints following rhinoplasty. METHODS A systematic search of Cochrane, Medline, and Embase databases was conducted in September 2022. The literature was screened independently by two reviewers, and the data were extracted. Our search terms included septorhinoplasty, rhinoplasty, osteotomy, splinting, nasal splinting, and external nasal splinting. RESULTS Initially, 1617 articles were identified, but only four articles were included in the final review. The included studies were all published between 2016 and 2021. The included studies recruited 2425 patients, 20 of whom used external splints and 2415 did not. Out of 2415 patients who did not use an external nasal splint, there were 151 patients with moderate periorbital edema and ecchymosis. There was a decrease in nasal width in 99% of the patients who did not use external nasal splinting postoperatively. CONCLUSION According to our findings, nasal splinting should not be routinely used following rhinoplasty, but only in certain patients. There is no clear evidence that nasal splints reduce complications, and complications occurred among both patients with and without external nasal splints. Further studies need to be conducted to confirm this conclusion. 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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Affiliation(s)
- Mohammed Khan
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
- Department of Plastic Surgery and Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia.
| | - Bassam AlRajhi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Alhanouf Alwagdani
- College of Medicine, King Saud University for Health Sciences, Jeddah, Saudi Arabia
| | - Wedyan Almosa
- Department of Otolaryngology, Head and Neck Surgery, Alnoor Specialist Hospital, Makkah, Saudi Arabia
| | - Khaled Almolhim
- Division of Otolaryngology, Department of Surgery, National Guard King Abdulaziz Hospital, Alahsa, Saudi Arabia
| | - Amani A Obeid
- Division of Facial Plastic Surgery, Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Omar Fouda Neel
- Division of plastic surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia
- Division of plastic surgery, Department of Surgery, McGill University, Montreal, Canada
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Application of 3D Imaging-Assisted Precise Aesthetic Evaluation in Midfacial Depression Treatment. Aesthetic Plast Surg 2022; 46:2799-2806. [PMID: 35475937 DOI: 10.1007/s00266-022-02867-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: 12/18/2021] [Accepted: 03/13/2022] [Indexed: 01/01/2023]
Abstract
Most Chinese have unpleasant facial profile of midfacial depression, which could be caused by multiple reasons. In the past, LeFort osteotomy and orthodontic methods were applied for surgical treatment of midfacial concavity. As the development of plastic surgery filling techniques, nasal base filling or concurrent comprehensive rhinoplasty has been widely used to improve midfacial depression. However, most of the related studies focus on surgical techniques or filling materials, yet lack accurate and objective aesthetic evaluation. In the current study, we used 3D imaging to collect 3D facial profile of 66 patients suffering from midfacial depression. Related linear distance and angles were measured accurately using 3D software. Patient satisfaction and physician evaluation were also collected in the follow-up period. The results showed that patients' midfacial depression were significantly improved after the surgery and the overall patient satisfaction was 100%. Our study demonstrated the positive role of nasal base filling in improving the midfacial depression, and illustrated the advantages of 3D imaging technology in personalized preoperative communication, surgical simulation and postoperative effect evaluation.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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Eldaly AS, Avila FR, Torres-Guzman RA, Maita K, Garcia JP, Palmieri Serrano L, Forte AJ. Simulation and Artificial Intelligence in Rhinoplasty: A Systematic Review. Aesthetic Plast Surg 2022; 46:2368-2377. [PMID: 35437664 DOI: 10.1007/s00266-022-02883-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rhinoplasty is one of the most popular cosmetic procedures. The complexity of the nasal structure and the substantial aesthetic and functional impact of the operation make rhinoplasty very challenging. The past few years have witnessed an increasing implementation of artificial intelligence (AI) and simulation systems into plastic surgery practice. This review explores the potential uses of AI and simulation models in rhinoplasty. METHODS Five electronic databases were searched: PubMed, CINAHL, EMBASE, Scopus, and Web of Science. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis as our basis of organization. RESULTS Several simulation models were described to predict the nasal shape that aesthetically matches the patient's face, indicate the implant size in augmentation rhinoplasty and construct three-dimensional (3D) facial images from two-dimensional images. Machine learning was used to learn surgeons' rhinoplasty styles and accurately simulate the outcomes. Deep learning was used to predict rhinoplasty status accurately and analyze the factors associated with increased facial attractiveness after rhinoplasty. Finally, a deep learning model was used to predict patients' age before and after rhinoplasty proving that the procedure made the patients look younger. CONCLUSION 3D simulation models and AI models can revolutionalize the practice of functional and aesthetic rhinoplasty. Simulation systems can be beneficial in preoperative planning, intra-operative decision making, and postoperative evaluation. In addition, AI models can be trained to carry out tasks that are either challenging or time-consuming for surgeons. 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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Affiliation(s)
- Abdullah S Eldaly
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - Francisco R Avila
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | | | - Karla Maita
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - John P Garcia
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - Luiza Palmieri Serrano
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - Antonio J Forte
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
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Gantous A, Ziai H. The Merits of the External Rhinoplasty. Facial Plast Surg 2021; 38:13-20. [PMID: 34327682 DOI: 10.1055/s-0041-1732480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The authors present their views on the merits of external rhinoplasty in the context of a renewed awareness of the endonasal approach. Why do we continue to perform rhinoplasty via an open approach? The benefits of this technique such as its unparalleled exposure, the opportunity for technical precision, and the ability to better preserve nasal function are thoroughly explored. The criticisms of this technique are presented and discussed. The authors thoughts on rhinoplasty as a whole are examined.
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Affiliation(s)
- Andres Gantous
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hedyeh Ziai
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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Halepas S, Lee KC, Castiglione C, Ferneini EM. Grafting in Modern Rhinoplasty. Oral Maxillofac Surg Clin North Am 2020; 33:61-69. [PMID: 33153889 DOI: 10.1016/j.coms.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Rhinoplasty is considered one of the most technically difficult surgical procedures because of the limited access and requirement for three-dimensional visual perception and manipulation. Grafting is an essential part of primary and secondary rhinoplasties and forms the foundation for a successful functional and aesthetic outcome. Septal cartilage is the most commonly used grafting material, although many reliable alternatives exist. No randomized clinical trials have been conducted comparing graft materials and techniques for specific indications. In this review, the authors discuss the most common grafting materials and configurations used in the modern rhinoplasty.
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Affiliation(s)
- Steven Halepas
- Division of Oral & Maxillofacial Surgery, Columbia University Medical Center, New York-Presbyterian, 622West 168th Street, Suite 7-250, New York, NY 10032, USA
| | - Kevin C Lee
- Division of Oral & Maxillofacial Surgery, Columbia University Medical Center, New York-Presbyterian, 622West 168th Street, Suite 7-250, New York, NY 10032, USA
| | - Charles Castiglione
- Division of Plastic Surgery, Hartford Hospital and Connecticut Children's Medical Center, University of Connecticut School of Medicine, 399 Farmington Avenue, Suite 210, Farmington, CT 06032, USA
| | - Elie M Ferneini
- Beau Visage Med Spa, Cheshire, CT, USA; Department of Surgery, Frank H Netter MD School of Medicine, Quinnipiac University, Hamden, CT, USA; Division of Oral & Maxillofacial Surgery, University of Connecticut, Farmington, CT, USA.
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Rhinoplasty and External Nasal Splinting: Is It Really a Must? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2374. [PMID: 31592389 PMCID: PMC6756671 DOI: 10.1097/gox.0000000000002374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/14/2019] [Indexed: 11/26/2022]
Abstract
Rhinoplasty is a common and challenging procedure. Lateral osteotomy is routinely performed in most cases. Most of the surgeons have the habit of applying external nasal splints to stabilize the nasal tissues and bone in their new position postrhinoplasty. These splints are widely used despite the absence of any evidence supporting this practice. Moreover, these splints have a lot of disadvantages, so we conducted this study to evaluate the cosmetic result in their absence.
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13-93B3 Bioactive Glass: a New Scaffold for Transplantation of Stem Cell-Derived Chondrocytes. J Craniofac Surg 2018; 29:233-236. [DOI: 10.1097/scs.0000000000004037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Guthrie A, Kadakia S, Cranford J, Sawhney R, Ducic Y. A Review of Complications and Their Treatments in Facial Aesthetic Surgery. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/0748806816689619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aesthetic surgery has become increasingly popular in the last several decades, with facial aesthetic surgery accounting for a large percentage of the procedures performed. With this surge in popularity and the increase in the number of cosmetic surgeries and procedures completed, comes an inevitable increase in the number of complications encountered. This review elucidates common complications and effective management of frequently performed cosmetic facial surgeries. This article represents a general overview of the topic. For a more exhaustive review, the reader is encouraged to turn their attention to the facial plastics and additional surgical subspecialty literature. Aesthetic procedures discussed in this article include rhinoplasty, rhytidectomy, facial augmentation, otoplasty, brow lift, blepharoplasty, skin resurfacing and chemical peels, and facial injections.
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Affiliation(s)
- Ashley Guthrie
- New York Eye and Ear Infirmary of Mount Sinai, New York City, NY, USA
| | - Sameep Kadakia
- New York Eye and Ear Infirmary of Mount Sinai, New York City, NY, USA
| | - Jeffrey Cranford
- New York Eye and Ear Infirmary of Mount Sinai, New York City, NY, USA
| | - Raja Sawhney
- University of Florida Health Science Center, Gainesville, FL, USA
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Dallas-Fort Worth, TX, USA
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