Evidence supporting functional rhinoplasty or nasal valve repair: A 25‐year systematic review

Rhee, John S.; Arganbright, Jill M.; McMullin, Brian T.; Hannley, Maureen

doi:10.1016/j.otohns.2008.02.007

Cited by 121 publications

(137 citation statements)

References 45 publications

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“…61 Techniques such as static and dynamic inspection, the modified Cottle maneuver (as depicted in Figure 5), 62 and palpation can augment the physical examination. 60,[63][64][65] Furthermore, the rhinoplasty surgeon should be cognizant of the dynamic nature of the operation and consider how attempts to alter the aesthetic appearance of the nose may affect nasal airway obstruction. For example, careful evaluation of the strength of the nasal tip and lower lateral cartilages is important, as too much resection in the setting of weak cartilage can lead to postoperative nasal obstruction.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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Objective. Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work.The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guideline, limited literature existed on standard care considerations for pre-and postsurgical management and for standard surgical practice to ensure optimal outcomes for patients undergoing rhinoplasty. The impetus for this guideline is to utilize current evidence-based medicine practices and data to build unanimity regarding the peri-and postoperative strategies to maximize patient safety and to optimize surgical results for patients.Purpose. The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The target audience is any clinician or individual, in any setting, involved in the management of these patients. The target patient population is all patients aged ≥15 years. The guideline is intended to focus on knowledge gaps, practice variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age.Action Statements. The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon's designee, should evaluate the rhinoplasty candidate for...

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Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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“…They have not been included in almost all the evaluations done so far and they make the relevancy of the research difficult. Anyway, significant respiratory pathological conditions and abnormalities were not frequent in our research [17,18].…”

Section: Discussionmentioning

confidence: 47%

Evaluation of the Frequency of the Accompanying Nasal Symptoms in Rhinoseptoplasty Patients

Barsova¹,

Nikolovski²

2017

JOENTR

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Background: The deviation of the nasal septum is one of the most frequent cause of nasal respiratory obstruction. Usually it appears parallel to a series of difficulties which additionally affect the patient's physical condition and disrupt their everyday activity and work. The patients with deviated nasal septum besides the chronic nasal obstruction as a dominant problem, state the following as the most frequent accompanying symptoms: rhinorrhea, nasal pain, headache, hyposmia, snoring, nasal speech and epistaxis.

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“…As a result, much of our knowledge in nasal valve surgery is based on retrospective reports. That being said, both Rhee et al [59] and Spielmann et al [10] found that despite the lack of level I data, there is good evidence that nasal valve surgery is beneficial for patients. In 2010, Rhee et al [6] proposed guidelines for treatment of nasal valve collapse based on available literature and expert consensus.…”

Section: Discussion/ebmmentioning

confidence: 99%

Update on the evidence for functional rhinoplasty techniques

Chan

Shipchandler

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of reviewFunctional rhinoplasty is a term that is commonly used to describe any technique used to address nasal obstruction in the nasal valve region. Etiology of nasal valve collapse differs based on the site. Internal valve collapse may be idiopathic or associated with previous rhinoplasty, trauma, or weakened cartilage in older patients. External valve collapse is usually idiopathic and less likely to be associated with previous surgery. Various techniques have been developed over time, and the data in support of functional rhinoplasty continues to increase. Recent findingsThis article discusses popular techniques currently in use as well as newer techniques that have been described over the past several years. In addition, there is a trend toward utilizing objective testing and validated assessment scales to assess post-operative changes. SummaryFunctional rhinoplasty utilizes a multitude of techniques to address nasal valve collapse. While high-level data is lacking, the current literature is in support of nasal valve correction to improve nasal breathing. Most importantly, the technique employed is unique for each patient.

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Evidence supporting functional rhinoplasty or nasal valve repair: A 25‐year systematic review

Cited by 121 publications

References 45 publications

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Evaluation of the Frequency of the Accompanying Nasal Symptoms in Rhinoseptoplasty Patients

Update on the evidence for functional rhinoplasty techniques

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