Endoscopic Sinus Surgery Associated with Rhinoseptoplasty: A Case-control Study

Abstract

Objective:To examine the difference between outcomes in the administration of concurrent endoscopic sinus surgery (ESS), septoplasty (SP), and rhinoplasty (RP) and concurrent ESS and SP in 1 single surgical session.Methods:Patients who underwent concurrent ESS and SP from September 2004 to July 2015 were identified. Furthermore, patients among them who underwent functional primary RP were selected. Subjects who had been administered concurrent ESS, SP, and RP (primary RP) were matched for sex, age, sinonasal surgical procedures for treatment of chronic rhinosinusitis with patients underwent concurrent ESS and SP, used as control subjects. A literature review was performed to find previous articles describing results of concurrent procedures among ESS, SP, and RP.Results:Twenty subjects, who underwent concurrent ESS, SP, and RP, were compared with a matched control group made of 20 patients who underwent concurrent ESS and SP, evaluating different postoperative outcomes (postoperative complications, postoperative improvement of respiratory symptoms, persistence of chronic rhinosinusitis symptoms 6 months to 1 year postoperative, need of revision surgery, satisfaction of the patient). Obtained P values showed that there was no statistically significant difference (P > 0.05) as regards the different outcomes, except for postoperative complications, increased because of the invasiveness proper of RP (P < 0.05).Conclusions:Therefore, execution of concurrent ESS, SP, and RP seems to be safe and effective, and additional RP does not modify postoperative outcomes of concurrent ESS and SP except for a little increase of postoperative complications, even if most of them had low impact on result of procedures.

Outcomes of Concurrent Functional Endoscopic Sinus Surgery and Rhinoplasty: A Meta-analysis

“…Recent studies also show that operating room time for combined FESS and rhinoplasty surgery compared to the sum of two standalone procedures appears to be less than staged surgeries for patients who would benefit from both surgeries resulting in lesser cost burden for the patient. 19 Operating time for combined surgeries in our study ranged from 110 to 215 minutes, whereas FESS ranged from 102 to 165 minutes and rhinoplasty ranged from 46 to 138.8 minutes. [13][14][15][16] However, it is equally important to consider the technical challenges of performing FESS around an externally dissected nose, which may fracture cartilage and bone and requires careful communication and coordination between the rhinoplasty and sinus surgeons (if done separately).…”

“…15 This was then followed by a series of five additional case-control studies with reported outcomes. 14,[16][17][18][19] However, these studies, all of which are included in our meta-analysis, again presented conflicting results on outcomes for combined surgeries.…”

“…9 Multiple studies, however, have demonstrated opposing results. [17][18][19]27,28 Furthermore, some of the studies included in our analysis excluded patients with severe disease whereas others did not compare disease/ surgery extent to postoperative outcomes. Lastly, there is potential for study bias.…”

Quality of Life Improvement in Concurrent Septorhinoplasty and Endoscopic Sinus Surgery

“…21 Marchica et al, in a matched casecontrol study, used the Rhinosinusitis Symptom Inventory to evaluate patient satisfaction in a retrospective data collection without preoperative measurements. 22 They found no differences between groups of each 20 patients with concurrent surgery or single SRPL.…”

Photographic Changes in the Alar Base Width in Using Modified Alar Cinch Technique Following Lefort I Osteotomy: A Narrative Review

“…Lefort I osteotomy is the most common type of surgery in the field of orthognathic surgery [1]. The secondary nasolabial changes following Lefort I osteotomy are well identified and include widening of the alar base, upturning of nasal tip, thinning and straightening of the upper lip [2].…”