Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty

Asher, Scott A.; Kakodkar, Akta S.; Toriumi, Dean M.

doi:10.1001/jamafacial.2017.1127

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Of 31 studies, all studies except 1 randomized clinical trial (3.2%) were observational in nature, with 21 retrospective studies (67.7%) and 9 prospective studies (29.0%). Conventional ECS was performed in 16 studies (51.6%), 20,22,24,25,[35][36][37][38][39][40][41][42][43][44][45][46] while the other 15 (48.4%) were modific ations of this technique, 21,26,27,[30][31][32][33][34][47][48][49][50][51][52][53] although heterogeneity of each technique used for every study was present. Sample size varied from 10 to 567, and the mean age varied from 22.5 to 46 years (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Of the estimates reported by Surowitz et al, 27 the total NOSE scores for the longest follow-up of 225 days was included and other estimates excluded from the meta-synthesis. The study by Asher et al 30 was excluded from meta-synthesis as total NOSE scores were not reported. Additionally, studies by Jang et al 34 and Gode et al 35 were excluded because variances were not reported along with average estimates.…”

Section: Discussionmentioning

confidence: 99%

“…Of the included 31 studies, [20][21][22][24][25][26][27] methodologically, 14 (45.2%) were considered to be good, 21,26,27,31,33,35-37,40,45,48,50-52 11 (35.5%) were considered poor, 22,24,25,38,39,41,42,46,47,49,53 and 6 (19.3%) were considered fair 20,30,32,34,43,44 (eTable 2 in the Supplement).…”

Section: Risk Of Systematic Biasmentioning

confidence: 99%

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Outcomes of Extracorporeal Septoplasty and Its Modifications in Treatment of Severe L-Strut Septal Deviation

Spataro

Saltychev

Kandathil

et al. 2019

JAMA Facial Plast Surg

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IMPORTANCE While extracorporeal septoplasty (ECS) and its modifications have been previously studied, to our knowledge, no systematic review of surgical outcomes and complications of this technique has been performed. OBJECTIVE To evaluate the evidence of surgical outcomes and complications of ECS (including modified techniques) to treat severe L-strut septal deviation defined as deviation within 1.0 cm of the caudal or dorsal septum.DATA SOURCES MEDLINE, Embase, CINAHL, CENTRAL, Scopus, and Web of Science databases and reference lists were searched from inception to April 2018 for clinical and observational studies. Search terms included extracorporeal, septoplasty, and septum.STUDY SELECTION Selection criteria were defined according to the population, intervention, comparison, and outcome framework. Relevant studies were selected by 2 independent reviewers based on abstracts and full texts.DATA EXTRACTION AND SYNTHESIS Data were extracted using standardized lists chosen by the authors according to Cochrane Collaboration guidelines. Data were collected and synthesized with ranges reported, as well as assessment of bias and heterogeneity when applicable. Analysis started in February 2019. MAIN OUTCOMES AND MEASURESOutcomes assessed included functional nasal airway improvement by objective measurements and subjective measurements (Nasal Obstruction Symptom Evaluation [NOSE] and visual analog scale scores); complications including bleeding, infection, dorsal irregularities, and other functional or cosmetic deficits; and as revision surgery rates. RESULTSOf 291 records initially obtained, 31 were considered relevant after review according to PRISMA guidelines. All studies except 1 randomized clinical trial (3.2%) were observational in nature, with 21 retrospective studies (67.7%) and 9 prospective studies (29.0%). Conventional ECS was performed in 16 studies (51.6%), and modified ECS was performed in 15 studies (48.4%). The sample size varied from 10 to 567, and the mean age varied from 22.5 to 46 years. Of 31 studies, 14 (45%) were of good methodology. Meta-analysis was performed on 5 studies reporting change in NOSE scores, with pooled effect of −60.0 (95% CI, −67.8 to −52.2) points, but heterogeneity was high, with I 2 = 96%. When comparing complications between modified and conventional ECS, the relative risk for infections was 0.95 (95% CI, 0.34-2.7); for bleeding, 0; for nasal dorsal irregularities, 0.29 (95% CI, 0.16-0.53); for other cosmetic complications, 4.3 (95% CI, 0.87-21.1); for other functional complications, 0.47 (95% CI, 0.20-1.1); and for revision operations, 1.4 (95% CI, 0.83-2.3). CONCLUSIONS AND RELEVANCEOf the 31 studies included in this systematic review, less than half were of good methodology, and a significant level of heterogeneity was found regarding type of outcome measure used and reporting of complications. To improve the level of evidence, better study methodology, standardization of surgical outcomes measures, and reporting of complications are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes of Extracorporeal Septoplasty and Its Modifications in Treatment of Severe L-Strut Septal Deviation

Spataro

Saltychev

Kandathil

et al. 2019

JAMA Facial Plast Surg

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“…9 This patient underwent shortening of his elongated septal L-strut to reduce the length of the nasal inlet and to reduce the effects of the tension deformity on the caudal septum. 10,11 This included anterior septal cartilage resizing and repositioning in the midline. The caudal septum was shortened via an endonasal approach and repositioned to the midline after a release from surrounding bony structures.…”

Section: Patient Selection and Characteristicsmentioning

confidence: 99%

Effect of Nasal Valve Shape on Downstream Volume, Airflow, and Pressure Drop: Importance of the Nasal Valve Revisited

Naughton

Lee

Ramos

et al. 2018

Ann Otol Rhinol Laryngol

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“…Literature reports various techniques to reconstruct the nasal septum, such as extracorporeal septoplasty and subtotal septal reconstruction [2][3][4][5] . Independently, technique shares the principle of creating a strong and straight 'L-shaped' structure in the midline, that is able to support the cartilaginous part of the external nose for functional and aesthetic purposes.…”

Section: Introductionmentioning

confidence: 99%

Functional and Aesthetic Outcomes of Septal Reconstructions: Results of a Prospective Longitudinal Outcome Study

Dam

Zijl

Lohuis³

et al. 2022

Facial Plast Surg

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Background In order to correct severe septal deformities, complete septal reconstruction is often required to achieve the desired functional and aesthetic results. Several different techniques have been described. Systematic evaluation of the long-term results is crucial to assess and improve the quality of these surgical techniques. Methods A custom-built dashboard (the rhinoplasty health care monitor (RHM)) was used for prospective and longitudinal outcome evaluation of the septal reconstruction. The RHM includes the Nasal Obstruction Symptom Evaluation (NOSE) scale for nasal obstruction and the Utrecht Questionnaire (UQ) for aesthetic outcome results. Results 58 patients were included for septal reconstructive surgery. The mean preoperative NOSE scale scores decreased from 67.8 ± 19.1 to 12.2 ± 17.5 1-year after surgery. Mean preoperative UQ scores went from 12.3 ± 6.4 to 6.2 ± 2.7. Conclusion The beneficial functional and aesthetic effects of the techniques that we currently use to reconstruct the septum are efficient in terms of function and aesthetics.

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Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty

Cited by 10 publications

References 31 publications

Outcomes of Extracorporeal Septoplasty and Its Modifications in Treatment of Severe L-Strut Septal Deviation

Outcomes of Extracorporeal Septoplasty and Its Modifications in Treatment of Severe L-Strut Septal Deviation

Effect of Nasal Valve Shape on Downstream Volume, Airflow, and Pressure Drop: Importance of the Nasal Valve Revisited

Functional and Aesthetic Outcomes of Septal Reconstructions: Results of a Prospective Longitudinal Outcome Study

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