Jahandideh Hesam, Maleki Delarestaghi Mojtaba, Jan Delaram, Sanaei Ayda
ENT and Head & Neck Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran.
Department of Otolaryngology Head and Neck Surgery, Firoozgar Hospital, Iran University of Medical Science, Tehran, Iran.
Int J Otolaryngol. 2020 Dec 18;2020:5929754. doi: 10.1155/2020/5929754. eCollection 2020.
The endonasal mucosal or anatomic pathologies could lead to poor functional results and dissatisfaction after rhinoplasty. Although computed tomography (CT) scan has become an integral part of the diagnostic paradigm for patients with pathologies of the paranasal sinuses, the use of CT scan for preoperative evaluation of patients seeking rhinoplasty is up for debate. Our aim in this study was to compare the efficacy of CT scan in diagnosing nasal pathologies with other evaluating tools in patients undergoing rhinoplasty.
In this randomized controlled trial study, 74 consecutive patients seeking cosmetic rhinoplasty referred to otorhinolaryngology clinic were randomly assigned into three groups based on the perioperative evaluation method: the CT group, the nasal endoscopy group, and the control group (anterior rhinoscopy only). Surgical planning was made according to perioperative findings, and the identified endonasal pathologies were corrected during the surgery. The functional and aesthetic outcomes of the rhinoplasty were assessed by Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and the Visual Analogue Scale (VAS) tools before surgery and at 12-month follow-up.
All outcome measures improved significantly in either group toward one year after rhinoplasty (all with value <0.05). Subjects in the CT group demonstrated greater improvement in the NOSE, VAS, and ROE compared to other two groups (NOSE: value = 0.17; VAS: value = 0.024; ROE: value = 0.042).
According to our study, perioperative CT is associated with greater patients' satisfaction and quality of life after rhinoplasty compared to either nasal endoscopy or anterior rhinoscopy. A preoperative CT scan may improve the outcomes of rhinoplasty.
鼻内黏膜或解剖结构异常可能导致隆鼻术后功能效果不佳和患者不满意。尽管计算机断层扫描（CT）已成为鼻窦疾病患者诊断模式中不可或缺的一部分，但CT用于隆鼻术前评估仍存在争议。本研究的目的是比较CT扫描与其他评估工具在隆鼻患者中诊断鼻腔疾病的有效性。
在这项随机对照试验研究中，74名连续转诊至耳鼻喉科诊所寻求美容隆鼻的患者根据围手术期评估方法被随机分为三组：CT组、鼻内镜组和对照组（仅前鼻镜检查）。根据围手术期检查结果制定手术计划，并在手术中纠正发现的鼻内病变。在手术前和术后12个月随访时，通过鼻阻塞症状评估（NOSE）、隆鼻结果评估（ROE）和视觉模拟量表（VAS）工具评估隆鼻的功能和美学效果。
隆鼻术后1年，两组的所有结局指标均有显著改善（均P值<0.05）。与其他两组相比，CT组患者在NOSE、VAS和ROE方面的改善更大（NOSE：P值=0.17；VAS：P值=0.024；ROE：P值=0.042）。
根据我们的研究，与鼻内镜检查或前鼻镜检查相比，围手术期CT与隆鼻术后患者更高的满意度和生活质量相关。术前CT扫描可能会改善隆鼻效果。
