Diced cartilage is one of the most widely used camouflage technique in rhinoplasty. Its variable resorption rate creates issues in postoperative time period. Platelet-rich fibrin is an autologous concentrated blood derivative containing growth factors that accelerate tissue healing. The authors evaluate the effect of injectable platelet-rich fibrin (I-PRF) on the viability of diced cartilage, which has been used for dorsum camouflage in rhinoplasty. Forty patients were randomly divided into two groups based on dorsal camouflage grafts: diced cartilage with I-PRF (study group) and diced cartilage without I-PRF (control group). Cartilage graft thickness was measured by linear superficial tissue ultrasound at the postoperative first week and the third month in both groups. The mean cartilage graft thickness loss between the first-week and third-month ultrasound measurements was 0.58 ± 0.21 mm in the study group and 0.82 ± 0.35 mm in the control group. There was significant volume loss in the control group. I-PRF was successful in reducing the resorption rate of diced cartilage on nasal dorsum by either increasing the viability or keeping its form. Sticky cartilage is an easily applicable and reliable technique that may be used to camouflage dorsal irregularities in rhinoplasty.
The study hypothesized the potential positive effects of platelet-rich fibrin (PRF) in postoperative rhinoplasty patients, such as better wound healing, less dead space, and less edema. The authors assessed PRF for nasal dorsum camouflage and studied its potential effects on nasal dorsal skin in rhinoplasty. Thirty-eight patients who underwent open approach primary rhinoplasty were categorized into two groups: nasal dorsal PRF group and control group. PRF membrane was used for nasal dorsum camouflage and laid over the bony dorsum and cartilage framework of the supratip area. Skin and subcutaneous soft tissue thickness were measured by linear superficial tissue ultrasound at the pre- and postoperative first week and the third month in both groups. Mean skin thickness over the supratip area was significantly higher in the control group in the first-week control. There were no significant differences in both first-week and third-month controls' nasal dorsum mean skin thickness measurements between the two groups. Regarding PRF complications, we encountered no complications in either group, including scarring, hematoma, infection, skin discoloration, and acne. The authors present the application of PRF membrane over the bony dorsum and cartilage framework of the supratip area. They observed its positive effect on postoperative edema, especially in the early postoperative period. Long-term investigations have to be performed to evaluate its potential effect on the rhinoplasty procedure. This was a level of evidence 3 study.
The objective of this study is to provide a valid and reliable Turkish version of the original Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). The SCHNOS questionnaire was translated from English to Turkish using standardized guidelines. Participants completed the questionnaire twice, with an interval of 7 to 10 days. Reliability and validity analyses were performed based on these answers. Differences between the rhinoplasty and control groups, the internal consistency of the instrument (Cronbach's alpha coefficient), and the strength of association between the two repeated measures (Pearson's correlation coefficient) were analyzed. Of the 188 included individuals (106 females, 82 males; mean age 28 ± 8.4 years), 97 were in the rhinoplasty group and 91 were in the control group. The mean total SCHNOS scores were 0.6 ± 0.4 and 29.4 ± 8.9 in the control and rhinoplasty groups, respectively, and there was a statistically significant difference in total scores between the groups (p < 0.001). The internal consistency reliability of the scale was found to be highly significant (Cronbach's alpha = 0.96, with a lower 95% confidence interval of 0.89). The test–retest correlation value was 0.95 for the total score, and each item had a strong test–retest correlation, ranging from 0.92 to 0.96. The Turkish version of the SCHNOS is a valid and reliable scale for evaluating both functional and cosmetic outcomes in Turkish-speaking patients undergoing rhinoplasty.
Purpose: Ecchymosis and edema are the most common complications in patients following rhinoplasty in the early postoperative period. Vasoconstriction created by hypocarbia may have a positive effect on postoperative ecchymosis. The aim of this study was to evaluate the effect of mild hypocapnia induced in rhinoplasty on the severity of periorbital ecchymosis. Methods: The study was carried out retrospectively in the digital photographs (control group and study group) of 31 participants who underwent open technical rhinoplasty between January and March 2019. During the operation, partial carbon dioxide pressure in the study group was kept in the range of 32 to 38 mmHg and in the control group between 42 and 46 mmHg and this was confirmed by arterial blood gas measurements taken during the operation. Measuring the brightness and shadows of digital photos Digital color meter was used in MacOS X as a computer software. Results: The mean ratio of periorbital ecchymosis to forehead brightness was 0.84 ± 0.05 in the study group and 0.81 ± 0.03 in the control group. There was no significant difference between the study and control groups ( P > .05). Conclusion: This study investigates the potential role of hypocapnia on postoperative ecchymosis during rhinoplasty. The severity of ecchymosis was less in the patients with induced mild hypocapnia regarding both subjective and objective evaluations, but this difference didn’t reach statistical significance compared to the normocapnic control group.
Introduction This collaborative European Academy of Plastic Surgery (EAFPS) study aimed to provide an overview of rhinoplasty practices, informing clinician and patient decision making. Methods Study design: Multicentre cross-sectional study, reported as per STROBE guidelines. Participants: All EAFPS members were contacted via email, inviting them to participate. Members expressing an interest to participate were asked to anonymously complete a questionnaire, related to rhinoplasties that they performed as first/supervising surgeon over period 1st January 2019 to 1st January 2022. A descriptive analysis was performed. Results One hundred and fifteen surgeons submitted data on 41,259 rhinoplasties from 33 countries. 80% of rhinoplasties were primary, and 20% were secondary. Thirty five percent of primary rhinoplasties were closed and 65% were open. Thirty one percent of primary rhinoplasties were for cosmetic indications, 11% functional and 58% were for both. Of the 8147 secondary rhinoplasties, 44% were closed and 56% were open. Thirty percent were for cosmetic indications, 11% functional and 59% for both cosmetic and functional. Ninety-one percent of rhinoplasties were performed by ENT surgeons, 3% by Plastic surgeons, 5% by Maxillo-facial surgeons, and 1% were dual (Maxillofacial and ENT) trained. 1730 primary rhinoplasties underwent revision surgery (5%) and 102 secondary rhinoplasties underwent revision surgery (1%). The most commonly reported indications for revision surgery were dorsal asymmetry, nasal blockage and dissatisfaction with nasal tip. Three percent of rhinoplasties underwent pre-operative psychological assessment. Discussion To the authors knowledge this the largest published rhinoplasty dataset. This study provides an overview of rhinoplasty practices that can be used for benchmarking and to guide clinician and patient decision making. Psychological assessment pre-rhinoplasty appears insufficient with higher levels recommended to minimise unsuccessful outcomes. This study showcases the power of collaborative research and may serve as a catalyst for future collaborative facial plastic surgery research.
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