Rhinoplasty from a Rhinologist's Perspective: Need for Recognition of Associated Sinonasal Conditions

Picavet, Valerie A.; Grietens, Jente; Jorissen, Mark; Hellings, Peter W.

doi:10.2500/ajra.2012.26.3816

Cited by 13 publications

(12 citation statements)

References 19 publications

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“…The primary focus of rhinoplasty in most cases is the improvement of the nasal shape. However, the concomitant pathologies of the nasal cavity are not to be disregarded as they may cause unresolved breathing and sinonasal problems and, thus, dissatisfaction after rhinoplasty [ 2 ]. A precise preoperative assessment for accurate determination of endonasal mucosal and structural pathologies is essential to ensure proper planning in primary rhinoplasty [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to CT scan limitations, including radiation exposure and increased cost [ 7 , 15 , 17 ], there is an argument on whether preoperative routine CT is truly necessary for these patients. On the other hand, the high prevalence of functional sinonasal symptoms and pathologies in patients seeking cosmetic rhinoplasty and their effects on surgical outcomes requires further studies to determine the impact of preoperative CT in these patients [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patients' satisfaction after rhinoplasty is one of the most important parameters of success and depends on good functional and aesthetic results [ 1 ]. According to previous studies, the primary reason for revision rhinoplasty is nasal tip asymmetry followed by breathing difficulties or nasal obstruction [ 2 ]. Therefore, the endonasal mucosal or anatomic pathologies which could lead to poor functional results and dissatisfaction should not be neglected when planning for surgery [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the endonasal mucosal or anatomic pathologies which could lead to poor functional results and dissatisfaction should not be neglected when planning for surgery [ 3 ]. A thorough perioperative assessment of patients can lead to proper patient selection, planning, and better functional and aesthetic outcomes [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

Jahandideh

Delarestaghi

Jan

et al. 2020

International Journal of Otolaryngology

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

Jahandideh

Delarestaghi

Jan

et al. 2020

International Journal of Otolaryngology

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“…In addition, patients with a crooked nose deformity can be caused by septal deviation, along with nasal obstruction. 5 Because most patients expect to remove both aesthetic appearance issues and nasal obstruction in one-step surgery, the functional rhinoseptoplasty may be a reasonable choice. Most septoplasties involve the submucous resection of the nasal septum.…”

mentioning

confidence: 99%

Tension-Relaxing Method—A Simplified Revision of the Endoscopic Septoplasty Technique: For Both Aesthetic Appearance and Functionality

Zuo

Jing

Zhou

et al. 2015

Am J Rhinol�Allergy

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Association of Mental Health Status With Perception of Nasal Function

Strazdins

Nie

Ramli

et al. 2017

JAMA Facial Plast Surg

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IMPORTANCE Mental health issues are thought to be overrepresented among patients undergoing rhinoplasty and may be associated with patient presentation prior to surgery.OBJECTIVE To assess the association of poor mental health with perception of nasal function. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study of patients presenting for airway assessment was performed from December 1, 2011, to October 31, 2015, at 2 tertiary rhinoplasty centers in Sydney, Australia. Mental health was independently defined preoperatively by the Mental Component Summary of the 36-item Short Form Health Survey version 2 (a score of <40 indicated poor mental well-being), the Rosenberg Self-Esteem Scale (a score of <15 indicated low self-esteem), and the Dysmorphic Concerns Questionnaire (a score of >11 indicated above-average dysmorphic concerns). MAIN OUTCOMES AND MEASURESNasal function was assessed with patient-reported outcome measures, including the Nasal Obstruction Symptom Evaluation Scale, the 22-item Sinonasal Outcome Test, a visual analog scale to rate ease of breathing on the left and right sides, and Likert scales to assess overall function and nasal obstruction. Nasal airflow was assessed by nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area.RESULTS Among 495 patients in the study (302 women and 193 men; mean [SD] age, 36.5 [13.6] years), compared with patients with good mental health, those with poor mental health had poorer scores in all patient-reported outcome measures, including the visual analog scale for the left side (mean [SD], 51 [25] vs 42 [25]; P = .001), visual analog scale for the right side (mean [SD], 54 [24] vs 45 [26]; P < .001), Nasal Obstruction Symptom Evaluation Scale (mean [SD], 2.64 [0.95] vs 1.96 [1.04]; P < .001), 22-item Sinonasal Outcome Test (mean [SD], 2.14 [0.84] vs 1.33 [0.83]; P < .001), nasal obstruction (58 of 145 [40.2%] vs 83 of 350 [23.7%] with severe or worse obstruction; P < .001), and nasal function (72 of 145 [49.7%] vs 111 of 350 [31.8%] with poor or worse function; P < .001). Subclinical differences in nasal peak inspiratory flow could be demonstrated, but all other nasal airflow measures were similar. Low self-esteem produced a similar pattern, but dysmorphia did not. CONCLUSIONS AND RELEVANCEPoor mental health status is associated with a poorer self-perception of nasal function compared with those who are mentally healthy with clinically similar nasal airflow. Clinicians should be aware that patients with poor mental health reporting obstructed airflow may in part be representing an extension of their negative emotions rather than true obstruction and may require further assessment prior to surgery.LEVEL OF EVIDENCE NA.

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Rhinoplasty from a Rhinologist's Perspective: Need for Recognition of Associated Sinonasal Conditions

Abstract: ABSTRACT

Cited by 13 publications

References 19 publications

Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

Tension-Relaxing Method—A Simplified Revision of the Endoscopic Septoplasty Technique: For Both Aesthetic Appearance and Functionality

Association of Mental Health Status With Perception of Nasal Function

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