Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Aesthetic Plast Surg. 2020 Feb;44(1):122-128. doi: 10.1007/s00266-019-01484-5. Epub 2019 Aug 28.
Cosmetic rhinoplasty has been linked to iatrogenic breathing disturbances using clinical tools. However, few studies have evaluated outcomes using validated, patient-centered instruments.
We aim to determine the incidence and severity of nasal obstruction following cosmetic rhinoplasty as measured by patient-centered, disease-specific instruments.
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.
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.
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.
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使用临床工具，已经将美容隆鼻术与医源性呼吸障碍联系起来。但是，很少有研究使用经过验证的、以患者为中心的工具来评估结果。
我们旨在通过以患者为中心的、针对特定疾病的器械，确定美容隆鼻术后鼻塞的发生率和严重程度。
这是一项对 2017 年 1 月至 2019 年 1 月在斯坦福医院接受美容隆鼻术的成年患者进行的回顾性研究。纳入一般人口统计学资料，以及鼻部阻塞和症状评估（NOSE）和标准化美容和健康鼻部结局调查（SCHNOS）问卷数据。术后随访时追踪评分，并与术前状态进行比较。患者分为驼峰去除、鼻尖矫正和两者兼有。
在纳入的 68 名患者中，56 名女性，平均年龄为 30.6 岁。尽管在第一个术后间隔，平均 SCHNOS 和 NOSE 评分增加，但在随后的每次就诊中，平均评分均下降。对于驼峰去除、鼻尖矫正或两者兼有的患者，SCHNOS 或 NOSE 评分均无显著增加。只有两名患者在最近的术后随访中记录的 NOSE 评分高于基线。
我们的结果表明，采用现代气道保护技术进行缩鼻术不会增加呼吸阻塞的风险。我们在第一次术后就诊时观察到的阻塞症状最初增加可能是由于围手术期肿胀，因为在随访就诊时有所改善。NOSE 和 SCHNOS 都是能够评估美容隆鼻术后鼻塞的以患者为中心的问卷。
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