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Aesthetic Plastic Surgery

, Volume 44, Issue 1, pp 122–128 | Cite as

Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty

  • Tyler Stephen Okland
  • Cherian Kandathil
  • Akshay Sanan
  • Shannon Rudy
  • Sam P. MostEmail author
Original Article Rhinoplasty
  • 105 Downloads

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.

Keywords

Cosmetic rhinoplasty Nasal obstruction SCHNOS NOSE Patient-reported outcome measures 

Notes

Funding

No funding was obtained for this study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, formal consent is not required.

References

  1. 1.
    Grymer LF (1995) Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 105:429–431CrossRefGoogle Scholar
  2. 2.
    Edizer DT, Erisir F, Alimoglu Y, Gokce S (2012) Nasal obstruction following septorhinoplasty: how well does acoustic rhinometry work? Eur Arch Otorhinolaryngol 270:609–613CrossRefGoogle Scholar
  3. 3.
    Celebi S, Caglar E, Yilmaz E et al (2014) Does rhinoplasty reduce nasal patency? Ann Otol Rhinol Laryngol 123(10):701–704CrossRefGoogle Scholar
  4. 4.
    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):331–335CrossRefGoogle Scholar
  5. 5.
    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):592–597CrossRefGoogle Scholar
  6. 6.
    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):341–345PubMedPubMedCentralGoogle Scholar
  7. 7.
    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):518–25Google Scholar
  8. 8.
    Lam DJ, James KT, Weaver EM (2006) Comparison of anatomic, physiological, and subjective measures of the nasal airway. Am J Rhinol 20(5):463–470CrossRefGoogle Scholar
  9. 9.
    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):157–163CrossRefGoogle Scholar
  10. 10.
    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):37–42CrossRefGoogle Scholar
  11. 11.
    Lipan MJ, Most SP (2013) Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plast Surg 15(5):358–361CrossRefGoogle Scholar
  12. 12.
    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):231–233CrossRefGoogle Scholar
  13. 13.
    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):126–128Google Scholar
  14. 14.
    Kandathil CK, Saltychev M, Abdelwahab M, Spataro EA, Moubayed SP, Most SP. Minimal clinically important difference of the standardized cosmesis and health nasal outcomes survey. Aesthet Surg J. sjz070, https://doi-org.laneproxy.stanford.edu/10.1093/asj/sjz070.
  15. 15.
    Grymer LF, Gregers-Petersen C, Baymler Pedersen H (1999) Influence of lateral osteotomies in the dimensions of the nasal cavity. Laryngoscope 109:936–938CrossRefGoogle Scholar
  16. 16.
    Zoumalan RA, Constantinides M (2012) Subjective and objective improvement in breathing after rhinoplasty. Arch Facial Plast Surg 14:423–428CrossRefGoogle Scholar
  17. 17.
    Erdogan M, Cingi C, Seren E (2012) Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods. Eur Arch Otorhinolaryngol 270:99–106CrossRefGoogle Scholar
  18. 18.
    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 71:162–174CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Division of Facial Plastic and Reconstructive SurgeryStanford University School of MedicineStanfordUSA

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