Foppiani Jose A, Joy Ngamthoiba, Hernandez Alvarez Angelica, Escobar-Domingo Maria J, Lee Daniela, Taritsa Iulianna C, Schuster Kirsten A, Aneken Nancy Maty, Lee Bernard T, Lin Samuel J
From the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.
Jalalabad Ragib Rabeya Medical College and Hospital, Jalalabad, Bangladesh.
Plast Reconstr Surg Glob Open. 2024 Aug 23;12(8):e6103. doi: 10.1097/GOX.0000000000006103. eCollection 2024 Aug.
The literature on patient-reported outcomes (PROs) discussing dorsal preservation rhinoplasty (DPR) and component dorsal hump reduction (CDHR) is scarce. This study aims to fill the gap in PROs between these techniques.
A systematic review was conducted to investigate PROs of DPR and CDHR. A proportion meta-analysis was conducted using Stata statistical software.
A total of 25 studies met our inclusion criteria, pooling 1706 participants, with 13 studies on CDHP and 12 studies on DPR. Overall satisfaction rates were high, varying from 84% to 100% across studies. A subgroup analysis revealed that both techniques exhibited equally high satisfaction with no statistical differences ( = 0.18). A random-effects model revealed that about two of 100 treated patients underwent revisions across our cohort (95% interquartile range: 0-4). Notably, the CDHR technique was associated with a significant 53.7-point reduction in the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS)-cosmetic domain [95% confidence interval (CI): -62.7 to -44.8, < 0.001], along with a meaningful improvement in SCHNOS-obstructive scores by -27.3 points (95% CI: -50.5 to -4.04, = 0.02). Conversely, the DPR was linked to a 55.3-point reduction in the SCHNOS-cosmetic domain (95% CI: -60.7 to -49.9, < 0.001), and a -19.5 point change in the SCHNOS-obstructive domain (95% CI: -27.9 to -11.1, < 0.001).
Although PROs are comparable, the literature suggests that CDHR outcomes may be better than DPR in alleviating obstructive symptoms, potentially offering an evidence-based choice for addressing functional concerns in rhinoplasty.
关于患者报告结局(PROs)讨论保留鼻背隆鼻术(DPR)和鼻背驼峰部分切除术(CDHR)的文献很少。本研究旨在填补这些技术在PROs方面的空白。
进行了一项系统评价以调查DPR和CDHR的PROs。使用Stata统计软件进行了比例荟萃分析。
共有25项研究符合我们的纳入标准,汇集了1706名参与者,其中13项研究涉及CDHP,12项研究涉及DPR。总体满意率很高,各研究的满意率从84%到100%不等。亚组分析显示,两种技术的满意度同样高,无统计学差异(P = 0.18)。随机效应模型显示,在我们的队列中,每100例接受治疗的患者中约有2例进行了翻修(95%四分位数间距:0 - 4)。值得注意的是,CDHR技术与标准化美容和健康鼻结局调查(SCHNOS)-美容领域显著降低53.7分相关[95%置信区间(CI):-62.7至-44.8,P < 0.001],同时SCHNOS-阻塞性评分有意义地改善了-27.3分(95% CI:-50.5至-4.04,P = 0.02)。相反,DPR与SCHNOS-美容领域降低55.3分相关(95% CI:-60.7至-49.9,P < 0.001),以及SCHNOS-阻塞性领域有-19.5分的变化(95% CI:-27.9至-11.1,P < 0.001)。
尽管PROs具有可比性,但文献表明,在缓解阻塞性症状方面,CDHR的结局可能优于DPR,这可能为解决隆鼻术中的功能问题提供基于证据的选择。