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Chen K, Zhou L. The Effect of Functional Rhinoplasty on Quality of Life: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2024; 48:847-854. [PMID: 37173413 DOI: 10.1007/s00266-023-03390-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The purpose of the study was to comprehensively review the effect of functional rhinoplasty on quality of life. METHODS Eligible studies before December 2022 were identified by searching PubMed, Ovid, and Embase databases. The meta-analysis was performed with Stata. Outcomes included NOSE, SNOT-22 scores, VAS of obstruction, and ROE. RESULTS Sixteen studies, involving a total of 971 patients, were included. Meta-analysis showed that functional rhinoplasty statistically reduced the NOSE, SNOT-22 scores, and VAS of obstruction and statistically increased the ROE score of patients. CONCLUSION Functional rhinoplasty could statistically significantly improve quality of life of patients. However, given the number and quality of included research, further thorough studies with a larger sample size of high-quality studies need to be conducted. 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)
- Kai Chen
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Li Zhou
- Core Facilities of West China Hospital, Chengdu, Sichuan, China
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Alaniz L, Vu C, Arora J, Stulginski A, Zhu X, Cordero J, Vyas RM, Pfaff MJ. Effective Local Anesthetic Use in Nasal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5151. [PMID: 37534108 PMCID: PMC10393085 DOI: 10.1097/gox.0000000000005151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 08/04/2023]
Abstract
Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. Methods The primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen d used to normalize effect size between studies. I2 and Q statistics were used to assess interstudy variability. Results Four studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size (P < 0.001). Opioid requirements were lower in the nerve block groups (P < 0.001), and patient satisfaction scores were higher (P < 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block (P < 0.001). Conclusions These findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control.
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Affiliation(s)
- Leonardo Alaniz
- From the School of Medicine, University of California Irvine, Irvine, Calif
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Cindy Vu
- From the School of Medicine, University of California Irvine, Irvine, Calif
| | - Jagmeet Arora
- From the School of Medicine, University of California Irvine, Irvine, Calif
| | - Avril Stulginski
- From the School of Medicine, University of California Irvine, Irvine, Calif
| | - Xiao Zhu
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Justin Cordero
- University of California Riverside, School of Medicine, Riverside, Calif
| | - Raj M. Vyas
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
- Pediatric Plastic Surgery, Children’s Hospital of California, Orange, Calif
| | - Miles J. Pfaff
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
- Pediatric Plastic Surgery, Children’s Hospital of California, Orange, Calif
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Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
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Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
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Whitcroft KL, Mancini L, Yousry T, Hummel T, Andrews PJ. Functional septorhinoplasty alters brain structure and function: Neuroanatomical correlates of olfactory dysfunction. FRONTIERS IN ALLERGY 2023; 4:1079945. [PMID: 37089704 PMCID: PMC10117949 DOI: 10.3389/falgy.2023.1079945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/09/2023] [Indexed: 04/09/2023] Open
Abstract
IntroductionWe previously demonstrated functionally significant structural plasticity within the central olfactory networks, in association with improved olfaction after surgical treatment of chronic rhinosinusitis (CRS). In order to confirm and expand on these findings, the primary aim of this study was to determine whether these same regions undergo functionally significant structural plasticity following functional septorhinoplasty (fSRP), in patients with non-CRS olfactory dysfunction (OD) of mixed cause. fSRP has previously been shown to improve olfactory function, and the secondary aim of this study was to provide initial insights into the mechanism by which fSRP affects olfaction.MethodsWe performed a pilot prospective, multimodal neuroimaging study in 20 participants undergoing fSRP, including patients with non-CRS OD of mixed cause, as well as normosmic surgical controls. Participants underwent psychophysical olfactory testing, assessment of nasal airway, structural and functional neuroimaging. This was performed pre- and postoperatively in patients, and preoperatively in controls.ResultsThere was a statistically and clinically significant improvement in mean psychophysical olfactory scores after surgery. This was associated with structural and functional plasticity within areas of the central olfactory network (anterior cingulate, orbitofrontal cortex, insula, temporal pole). Improved psychophysical scores were significantly correlated with change in bilateral measures of nasal airflow, not measures of airflow symmetry, suggesting that improved overall airflow was more important than correction of septal deviation.ConclusionThis work highlights the importance of these neuroanatomical regions as potential structural correlates of olfactory function and dysfunction. Our results also provide initial insight into the mechanistic effects of fSRP on olfaction. Further work could investigate the utility of these regions as personalised biomarkers of OD, as well as the role of fSRP in treating OD.
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Affiliation(s)
- Katherine L. Whitcroft
- UCL Ear Institute, University College London, London, United Kingdom
- Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, University of London, London, United Kingdom
- Department of Rhinology and Facial Plastics, Royal National Throat Nose and Ear Hospital, London, United Kingdom
- Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- Correspondence: Katherine L. Whitcroft
| | - Laura Mancini
- Lysholm Department of Neuroradiology, the National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, the National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Thomas Hummel
- Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Peter J. Andrews
- UCL Ear Institute, University College London, London, United Kingdom
- Department of Rhinology and Facial Plastics, Royal National Throat Nose and Ear Hospital, London, United Kingdom
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Sousa FAD, Santos M, Correia JT, Pinto AN, Meireles L, Ferreira M. Septorhinoplasty and the Late Impact on Olfactory Function: A Review and Meta-analysis. Facial Plast Surg 2023; 39:69-76. [PMID: 36384241 DOI: 10.1055/a-1979-8636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Septorhinoplasty (SRP) is one of the most commonly performed procedures worldwide. There is a recognized debate about the impact of nasal surgery on olfactory function (OF). The study's objective was to assess the effect of SRP on late postoperative OF. A comprehensive review and meta-analysis were employed to assess OF after SRP. All the integrated studies used objective instruments to quantify OF before and after surgery. A literature search was conducted, and the selected works were evaluated, computed, and finally included in a meta-analysis. The risk of bias was assessed using the NIH Guidance for Evaluating the Quality of Before-After (Pre-Post) Studies with No Control Group. Only the latest follow-up OF measurements provided by each research were considered in the analysis. The 95% confidence interval of the effect magnitude for each study was calculated to elucidate effect sizes. Eleven studies were included in the analysis. Five studies reported late OF improvement (45.5%), five reported no alteration in OF (45.5%), and only one study reported OF impairment after SRP (9%). Some works described a transitory decline in OF shortly following surgery, followed by postoperative improvement. A pooled meta-analysis showed that OF was not significantly altered after SRP (p = 0.10) in the late follow-up. SRP surgery seems to constitute a safe procedure concerning OF in the long term. According to research, OF may deteriorate temporarily after surgery with later improvement, sometimes to higher values than baseline. The anticipated evolution of OF after intervention could be discussed during the preoperative consultation for SRP.
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Affiliation(s)
- Francisco Alves de Sousa
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mariline Santos
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Tavares Correia
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Nóbrega Pinto
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Ferreira
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
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Powered Micro-saw Versus Conventional Osteotome for Septorhinoplasty: A Prospective, Double-Blind, Comparative Study. Aesthetic Plast Surg 2022; 47:1133-1141. [DOI: 10.1007/s00266-022-03083-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/21/2022] [Indexed: 01/13/2023]
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Discussion: The Effect of Functional Nasal Surgery on Olfactory Function. Plast Reconstr Surg 2021; 147:719-720. [PMID: 33620942 DOI: 10.1097/prs.0000000000007668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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