Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, 40 Duke Medicine Circle, Durham, NC, 27710, USA.
Aesthetic Plast Surg. 2023 Jun;47(3):1155-1161. doi: 10.1007/s00266-022-03155-4. Epub 2022 Oct 28.
Rhinoplasty is one of the most common aesthetic surgical procedures, and yet its postoperative complication profile remains somewhat ill-defined and underreported. The purpose of this study was to examine the quality of complication reporting in the rhinoplasty literature and provide a framework for future complication classification.
Studies were identified from a previously published 2019 systematic review conducted at Duke University Medical Center. Each included study was again reviewed to determine the reported complications and definitions. Reported complications were analyzed to determine occurrence rate, definition presence/absence, definition location, subjectivity/objectivity, and presence of severity grading system.
A total of 30 studies were included. Overall, 63% (n = 19) of studies failed to provide a single definition for any reported complications. The remaining 11 studies (37%) provided at least one definition for their reported complications. Grading/severity scales were included by 8 studies. A specific complication was identified as a "primary outcome" in 15 cases. Definitions were included for 11 (73%) of these 15 complications. Complications denoted as "primary outcomes" were significantly more likely to have an included definition (p <0.01).
Postoperative complications following rhinoplasty are inadequately defined in the available literature, with over sixty percent of studies failing to define a single-reported complication. When complication definitions are included, they are often subjective in nature and rarely include a grading or severity scale. In the absence of standardized rhinoplasty complication definitions, comparing complication rates across studies is exceedingly difficult, and the ability to conduct high-quality meta-analyses is limited.
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 .
隆鼻术是最常见的美容外科手术之一，但术后并发症的情况仍有些模糊和报告不足。本研究旨在检查隆鼻文献中并发症报告的质量，并为未来的并发症分类提供框架。
研究是在杜克大学医学中心进行的 2019 年系统综述中确定的。对每个纳入的研究进行再次审查，以确定报告的并发症和定义。分析报告的并发症以确定发生率、定义存在/不存在、定义位置、主观性/客观性以及严重程度分级系统的存在。
共纳入 30 项研究。总体而言，63%（n=19）的研究未能为任何报告的并发症提供单一定义。其余 11 项研究（37%）为报告的并发症提供了至少一个定义。8 项研究纳入了分级/严重程度量表。15 例中确定了一种特定的并发症作为“主要结局”。这些 15 种并发症中的 11 种（73%）包含定义。被标记为“主要结局”的并发症更有可能包含定义（p<0.01）。
隆鼻术后并发症在现有文献中定义不足，超过 60%的研究未能定义单一报告的并发症。当包含并发症定义时，它们通常具有主观性，很少包含分级或严重程度量表。在缺乏标准化的隆鼻并发症定义的情况下，比较研究之间的并发症发生率非常困难，并且进行高质量的荟萃分析的能力受到限制。
证据等级 III：本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266。
