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Published in: Aesthetic Plastic Surgery 1/2020

01-02-2020 | Rhinoplasty | Original Article

Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty

Authors: Tyler Stephen Okland, Cherian Kandathil, Akshay Sanan, Shannon Rudy, Sam P. Most

Published in: Aesthetic Plastic Surgery | Issue 1/2020

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Abstract

Background

Cosmetic rhinoplasty has been linked to iatrogenic breathing disturbances using clinical tools. However, few studies have evaluated outcomes using validated, patient-centered instruments.

Objective

We aim to determine the incidence and severity of nasal obstruction following cosmetic rhinoplasty as measured by patient-centered, disease-specific instruments.

Design

This is a retrospective review of adult patients who underwent cosmetic rhinoplasty at Stanford Hospital between January 2017 and January 2019. General demographic as well as Nasal Obstruction and Symptom Evaluation (NOSE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire data were included. Scores were tracked across postoperative visits and compared to the preoperative state. Patients were subdivided into dorsal hump takedown, correction of the nasal tip, and both.

Results

Of the 68 included patients, 56 were women, and the mean age was 30.6 years. Although mean SCHNOS and NOSE scores increased at the first postoperative interval, mean scores decreased on each subsequent visit. There were no significant increases in SCHNOS or NOSE scores for either dorsal hump takedown, tip correction, or both. There were only two patients who recorded NOSE scores higher than baseline at most recent postoperative visit.

Conclusion

Our results indicate reductive rhinoplasty is not associated with a greater risk of breathing obstruction when performed with modern airway preservation techniques. The initial increases in obstructive symptoms we observed on the first postoperative visit likely represent perioperative swelling given the improvement on follow-up visits. Both the NOSE and SCHNOS are patient-centered questionnaires capable of evaluating nasal obstruction following cosmetic rhinoplasty.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Grymer LF (1995) Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 105:429–431CrossRef Grymer LF (1995) Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 105:429–431CrossRef
2.
go back to reference Edizer DT, Erisir F, Alimoglu Y, Gokce S (2012) Nasal obstruction following septorhinoplasty: how well does acoustic rhinometry work? Eur Arch Otorhinolaryngol 270:609–613CrossRef Edizer DT, Erisir F, Alimoglu Y, Gokce S (2012) Nasal obstruction following septorhinoplasty: how well does acoustic rhinometry work? Eur Arch Otorhinolaryngol 270:609–613CrossRef
3.
go back to reference Celebi S, Caglar E, Yilmaz E et al (2014) Does rhinoplasty reduce nasal patency? Ann Otol Rhinol Laryngol 123(10):701–704CrossRef Celebi S, Caglar E, Yilmaz E et al (2014) Does rhinoplasty reduce nasal patency? Ann Otol Rhinol Laryngol 123(10):701–704CrossRef
4.
go back to reference Bloom JD, Sridharan SS, Hagiwara M et al (2012) Reformatted computed tomography to assess the internal nasal valve and association with physical examination. Arch Fac Plast Surg 14(5):331–335CrossRef Bloom JD, Sridharan SS, Hagiwara M et al (2012) Reformatted computed tomography to assess the internal nasal valve and association with physical examination. Arch Fac Plast Surg 14(5):331–335CrossRef
5.
go back to reference Moche JA, Cohen JC, Pearlman SJ et al (2013) Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint. Int Forum Allergy Rhinol 3(7):592–597CrossRef Moche JA, Cohen JC, Pearlman SJ et al (2013) Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint. Int Forum Allergy Rhinol 3(7):592–597CrossRef
6.
go back to reference de Pochat VD, Alonso N, Mendes RR et al (2012) Assessment of nasal patency after rhinoplasty through the Glatzel mirror. Int Arch Otorhinolaryngol 16(3):341–345PubMedPubMedCentral de Pochat VD, Alonso N, Mendes RR et al (2012) Assessment of nasal patency after rhinoplasty through the Glatzel mirror. Int Arch Otorhinolaryngol 16(3):341–345PubMedPubMedCentral
7.
go back to reference Andres RF, Vuyk HD, Ahmed A et el. Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol. 2009, 34(6):518–25 Andres RF, Vuyk HD, Ahmed A et el. Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol. 2009, 34(6):518–25
8.
go back to reference Lam DJ, James KT, Weaver EM (2006) Comparison of anatomic, physiological, and subjective measures of the nasal airway. Am J Rhinol 20(5):463–470CrossRef Lam DJ, James KT, Weaver EM (2006) Comparison of anatomic, physiological, and subjective measures of the nasal airway. Am J Rhinol 20(5):463–470CrossRef
9.
go back to reference Stewart MG, Witsell DL, Smith TL et al (2004) Development and validation of the nasal obstruction symptom evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157–163CrossRef Stewart MG, Witsell DL, Smith TL et al (2004) Development and validation of the nasal obstruction symptom evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157–163CrossRef
10.
go back to reference Moubayed SP, Ioannidis JP, Saltychev M, Most SP (2018) The 10-item standardized cosmesis and health nasal outcomes survey (SCHNOS) for functional and cosmetic rhinoplasty. JAMA Fac Plast Surg 20(1):37–42CrossRef Moubayed SP, Ioannidis JP, Saltychev M, Most SP (2018) The 10-item standardized cosmesis and health nasal outcomes survey (SCHNOS) for functional and cosmetic rhinoplasty. JAMA Fac Plast Surg 20(1):37–42CrossRef
11.
go back to reference Lipan MJ, Most SP (2013) Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plast Surg 15(5):358–361CrossRef Lipan MJ, Most SP (2013) Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plast Surg 15(5):358–361CrossRef
12.
go back to reference Yoo S, Most SP (2011) Nasal airway preservation using the autospreader technique: analysis of outcomes using a disease-specific quality-of-life instrument. Arch Fac Plast Surg 13(4):231–233CrossRef Yoo S, Most SP (2011) Nasal airway preservation using the autospreader technique: analysis of outcomes using a disease-specific quality-of-life instrument. Arch Fac Plast Surg 13(4):231–233CrossRef
13.
go back to reference Murakami CS, Barrera JE, Most SP (2009) Preserving structural integrity of the alar cartilage in aesthetic rhinoplasty using a cephalic turn-in flap. Arch Fac Plast Surg 11(2):126–128 Murakami CS, Barrera JE, Most SP (2009) Preserving structural integrity of the alar cartilage in aesthetic rhinoplasty using a cephalic turn-in flap. Arch Fac Plast Surg 11(2):126–128
15.
go back to reference Grymer LF, Gregers-Petersen C, Baymler Pedersen H (1999) Influence of lateral osteotomies in the dimensions of the nasal cavity. Laryngoscope 109:936–938CrossRef Grymer LF, Gregers-Petersen C, Baymler Pedersen H (1999) Influence of lateral osteotomies in the dimensions of the nasal cavity. Laryngoscope 109:936–938CrossRef
16.
go back to reference Zoumalan RA, Constantinides M (2012) Subjective and objective improvement in breathing after rhinoplasty. Arch Facial Plast Surg 14:423–428CrossRef Zoumalan RA, Constantinides M (2012) Subjective and objective improvement in breathing after rhinoplasty. Arch Facial Plast Surg 14:423–428CrossRef
17.
go back to reference Erdogan M, Cingi C, Seren E (2012) Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods. Eur Arch Otorhinolaryngol 270:99–106CrossRef Erdogan M, Cingi C, Seren E (2012) Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods. Eur Arch Otorhinolaryngol 270:99–106CrossRef
18.
go back to reference Ottaviano G, Fokkens WJ (2016) Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy 71:162–174CrossRef Ottaviano G, Fokkens WJ (2016) Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy 71:162–174CrossRef
Metadata
Title
Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty
Authors
Tyler Stephen Okland
Cherian Kandathil
Akshay Sanan
Shannon Rudy
Sam P. Most
Publication date
01-02-2020
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2020
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01484-5

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