Bouaoud Jebrane, Loustau Marine, Belloc Jean-Baptiste
Department of Otolaryngology and Head and Neck Surgery, Changeux Building, Simone Veil Hospital, Eaubonne, France.
Department of Public Health and Social Medicine, Simone Veil Hospital, Eaubonne, France.
Plast Reconstr Surg Glob Open. 2018 Sep 5;6(9):e1884. doi: 10.1097/GOX.0000000000001884. eCollection 2018 Sep.
Surgical revision rate of rhinoplasty is from 5% to 15% in literature. The aims of our study were to define the rate and the predictive factors for surgical revision of rhinoplasty.
We have realized a single-center case/control study including 62 patients who underwent surgical revision among 732 patients who underwent closed rhinoplasty between 2005 and 2015. Data of each rhinoplasty were collected from medical records and photographs. Statistical analyses were used.
The surgical revision rate was 8.6%. After multivariate analysis, 4 factors were statistically significant and independently associated with surgical revision: "preexisting respiratory functional disorder" [odds ratio OR = 3.30; 95% CI (1.47-7.76); = 0.004], "wide nasal bone and side walls" [OR = 3.94; 95% CI (1.49-11.25); = 0.007], "deviated nasal bone and side walls" [OR = 2.68; 95% CI [1.14-6.58]; = 0.02] and the use of camouflage grafts [OR = 0.26; 95% CI [0.07-0.89]; = 0.04].
Closed rhinoplasties have similar revision rate to open techniques. Revision surgeries are justified by functional or aesthetic disorders. The interests of this study are to better inform patients and to adapt operative management. We provide here some recommendations with focus on the keys to successful rhinoplasty surgery.
文献报道隆鼻手术的再次手术率为5%至15%。我们研究的目的是确定隆鼻手术再次手术的发生率及其预测因素。
我们开展了一项单中心病例对照研究，纳入了2005年至2015年间接受闭合式隆鼻手术的732例患者中的62例接受再次手术的患者。从病历和照片中收集每次隆鼻手术的数据，并进行统计分析。
再次手术率为8.6%。多因素分析后，有4个因素具有统计学意义且与再次手术独立相关：“既往存在呼吸功能障碍”[比值比OR = 3.30；95%置信区间(1.47 - 7.76)；P = 0.004]，“鼻骨及侧壁宽大”[OR = 3.94；95%置信区间(1.49 - 11.25)；P = 0.007]，“鼻骨及侧壁偏斜”[OR = 2.68；95%置信区间[1.14 - 6.58]；P = 0.02]以及使用掩饰性移植物[OR = 0.26；95%置信区间[0.07 - 0.89]；P = 0.04]。
闭合式隆鼻手术的再次手术率与开放式技术相似。再次手术是由功能或美学障碍所决定的。本研究的意义在于更好地告知患者并调整手术管理。我们在此提供一些建议，重点关注隆鼻手术成功的关键。
