Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

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.

Evidence-Based Medicine: Rhinoplasty Surgical Outcomes

“…33 However, a randomized control trial by Jahandideh et al of 74 patients undergoing cosmetic rhinoplasty found that patients receiving pre-operative CT evaluation before surgery had significantly greater improvement in several different patient reported outcome measures (PROMs) compared to those randomized to nasal endoscopy alone, thought to be due to a higher prevalence of endonasal pathology identified with imaging. 35…”

A systematic review and meta-analysis of rhinoplasty using the rhinoplasty outcome evaluation scale

“…Papers were thoroughly read, discussed, and considered for the meta-analysis and major data reported [ Table 1 ]. [ 14 16 22 23 24 25 26 27 28 29 30 31 32 33 34 ]…”

Rhinoplasty Pre-Surgery Models by Using Low-Dose Computed Tomography, Magnetic Resonance Imaging, and 3D Printing

“…4 More frequently, the nose's structures are studied using computed tomography. 5 Such technology allows the high spatial resolution analysis of most parts of the nose, especially the bone components. However, CT has a non-negligible biological risk related to the high amount of ionizing radiation emitted by the scanner.…”