A multivariate analysis after preservation rhinoplasty (PR) – a prospective study

Stergiou, Georges; Fortuny, Clara Guardiola; Schweigler, Adrian; Finocchi, Valerio; Saban, Yves; Tremp, Mathias

doi:10.1016/j.bjps.2021.05.073

Cited by 14 publications

(12 citation statements)

References 23 publications

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“…The possibility of obtaining a totally smooth nasal contour after the correction of a hump, leaving this area intact, was championed by Saban [4,10,11] and Cakir [39] and has garnered the enthusiasm of many surgeons around the world. This goes in line with recent publications, where it has been shown that a high patient satisfaction can be achieved after PR as evaluated by the Rhinoplasty Outcomes Evaluation Questionnaire (= ROE) [40][41][42][43]. Nevertheless, hybridization between preservation and structural rhinoplasty can be performed including septal extracorporeal reconstruction or the swinging door technique together with dorsum PR (''hybrid operation'') [4,7].…”

Section: Discussionsupporting

confidence: 80%

“…Our article has limitations: There is a lack of objective measurements such as rhinomanometry and validated subjective patient reported outcome measures. Nevertheless, it has just recently been reported that a high patient satisfaction after PR can be achieved, as evaluated by the ROE, which goes in line with aesthetics and function [41][42][43]. Lastly, further studies are needed by using also the septal extracorporeal reconstruction technique, even endonasally together with dorsum PR [4].…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles

Tremp

Schneider

Raghu³

et al. 2023

Aesth Plast Surg

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Background A deviated nose is a common problem among patients for both cosmetic and functional reasons. The correction remains a major challenge for the rhinoplasty surgeon. Unrecognized nasal septal deviations stand as the primary reason for failed rhinoplasty outcomes. There is a paucity of data in the literature about septoplasty classifications and technical details in preservation rhinoplasty (PR) for various crooked noses. Materials and Methods The aim of this article is to provide a comprehensive overview of the various septum deviations according to the nasal axis. Moreover, a treatment algorithm is suggested with technical details based on PR principles. Results The directions and curvature of the cartilaginous deviation of crooked nose such as C-shaped, reverse C-shaped, straight axis deviations (I-shaped), and S-shaped are described. According to the deviation, a septoplasty classification (Type 1–Type 4) is suggested. Conclusions On the basis of septal deviation, different PR techniques are proposed to achieve the desired straight nasal dorsum with an optimal functional outcome. Compared to the classical L-strut concept, the quadrangular cartilage remains preserved in the swinging door technique. The cartilage might be further used in the future for grafting in the hybrid structural/preservation technique if needed, ultimately saving rib cartilage and/or conchal cartilage. Finally, surgery time is reduced, and patient’s morbidity remains minimal. Level of Evidence III 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.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles

Tremp

Schneider

Raghu³

et al. 2023

Aesth Plast Surg

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“…1,2,8,10,11,[14][15][16][17]20,33,35,37,39,[45][46][47][48] Overall, the DPR techniques are reported to have a complication rate ranging from 0 to 25.80% with the majority of reported complications being minor. 1,9,10,12,13,[16][17][18][23][24][25][26][27]30,34,35,37,39,40,44,46 Reported postoperative dorsal hump recurrence rates ranged from 0 to 36.9% with the most dorsal hump recurrence occurring following the classical septum pyramidal adjustment and repositioning (SPAR) approach in complex rhinoplasty cases. 1,2,7,13,[15][16][17][18][20]…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

State of the Evidence for Preservation Rhinoplasty: A Systematic Review

et al. 2023

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Preservation rhinoplasty encompasses a number of techniques that minimize disruption of the native cartilaginous and soft tissue nasal architecture. These techniques have gained popularity resulting in an increase in publications relevant to preservation rhinoplasty. However, many studies that present patient outcomes are of low-level evidence and do not incorporate validated patient-reported outcome measures. While these studies do consistently report positive outcomes, there are few high-level comparative studies that support the theoretical benefits of preservation relative to structural rhinoplasty. As contemporary preservation rhinoplasty techniques will continue to evolve and become incorporated into clinical practice, there will be the need for parallel emphasis on robust clinical studies to delineate the value of these methods.

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“…While it appears a logical assumption that function would not be compromised in the CPD approach, this could be an issue in FLD procedures where the likelihood of airway compromise has been an initial concern. Several studies however reported positive functional outcomes with dorsal preservation, 4,8,10,14,31,[35][36][37][38][39] although in all instances the osseocartilaginous vault had been mobilized as a single unit. Our technique differs, since it implies a dorsal split and subsequent resuture (►Fig.…”

Section: Discussionmentioning

confidence: 99%

Modified Dorsal Split Preservation Hybrid Rhinoplasty for Cartilaginous Pushdown and Full Letdown Applications: A PROM-Based Review of 100 Consecutive Cases

Robotti¹,

Cottone

Leone³

2023

Facial Plast Surg

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Splitting the middle vault on an anatomical plane along the “Septal T” allows a new hybrid perspective on the many modifications of “surface” preservation techniques. The “dorsal split preservation” concept can be applied both to cartilaginous pushdown as well as to full letdown techniques. The dorsal keystone area (DKA) is maintained, while the middle vault is reshaped. The septum is addressed by conventional L strut septoplasty. Precise direct suture fixation of the high-middle strip is easily accomplished after flexing the osseous-chondral junction at the K area. Specific technical points are described to allow exact and stable configuration of the dorsum. A retrospective analysis on 100 consecutive patients demonstrated aesthetic and functional improvement.

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A multivariate analysis after preservation rhinoplasty (PR) – a prospective study

Cited by 14 publications

References 23 publications

A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles

A Systematic Analysis of the Nasal Septum in Crooked Noses and Suggested Treatment Algorithm According to Preservation Rhinoplasty (PR) Principles

State of the Evidence for Preservation Rhinoplasty: A Systematic Review

Modified Dorsal Split Preservation Hybrid Rhinoplasty for Cartilaginous Pushdown and Full Letdown Applications: A PROM-Based Review of 100 Consecutive Cases

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