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保留鼻背与部分鼻背驼峰降低鼻整形术:患者报告结局的评估

Dorsal Preservation versus Component Dorsal Hump Reduction Rhinoplasty: An Assessment of Patient-reported Outcomes.

作者信息

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

机构信息

From the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.

Jalalabad Ragib Rabeya Medical College and Hospital, Jalalabad, Bangladesh.

出版信息

Plast Reconstr Surg Glob Open. 2024 Aug 23;12(8):e6103. doi: 10.1097/GOX.0000000000006103. eCollection 2024 Aug.

Abstract

BACKGROUND

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.

METHODS

A systematic review was conducted to investigate PROs of DPR and CDHR. A proportion meta-analysis was conducted using Stata statistical software.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/953b/11343546/1c5e1b5e3b5a/gox-12-e6103-g001.jpg

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