Garrard A, Davies T, Walker N, Raja H
Arrowe Park Hospital, UK.
Countess of Chester Hospital, UK.
Ann R Coll Surg Engl. 2025 May;107(5):369-372. doi: 10.1308/rcsann.2024.0081. Epub 2024 Sep 24.
Septorhinoplasty addresses both functional and cosmetic concerns with the nose and has been shown to have consistent, long-term benefits for patients. Nasal irrigation and medication such as antimicrobials are prescribed postoperatively to improve outcomes. Patient compliance with these interventions and outcomes of surgery have not been described. We aim to describe what the effects of compliance with these interventions may be in long-term follow-up.
Patients undergoing septorhinoplasty were reviewed prospectively from 2015 to 2022. At time of operation, patients were prescribed medications, saline douching and given smoking cessation advice. Patients underwent rhinoplasty outcomes evaluation (ROE) preoperatively, at four weeks, and 3, 12, 24 and 36 months postoperatively. Compliance with postoperative interventions was measured at four weeks. Statistical tests were performed.
A total of 56 patients underwent septorhinoplasty. Preoperative ROE scores were improved significantly at all stages of postprocedure follow-up (<0.0001). Multiple linear regression found no significant differences in patients who were not compliant with medications (>0.40), nasal douching (>0.22), both medication and nasal douching (>0.40), and a positive smoking status (>0.11) at four weeks. At 3- and 24-months follow-up, there were no significant differences in ROE scores between compliant patients and those who were noncompliant with medications, nasal douching or both (>0.13).
Our data represent the only series of patient-reported outcomes from septorhinoplasty patients where compliance with nasal irrigation, smoking cessation and antimicrobials is considered. Compliance with nasal irrigation, topical antimicrobials or smoking cessation did not influence postoperative ROE scores.
鼻中隔成形术可解决鼻子的功能和美观问题,并且已证明对患者具有持续的长期益处。术后会开具鼻腔冲洗和抗菌药物等药物以改善治疗效果。尚未描述患者对这些干预措施的依从性以及手术效果。我们旨在描述在长期随访中依从这些干预措施可能产生的影响。
对2015年至2022年接受鼻中隔成形术的患者进行前瞻性研究。手术时,为患者开具药物、生理盐水冲洗并提供戒烟建议。患者在术前、术后四周、3个月、12个月、24个月和36个月接受鼻整形术效果评估(ROE)。在术后四周测量对术后干预措施的依从性。进行了统计检验。
共有56例患者接受了鼻中隔成形术。在术后随访的各个阶段,术前ROE评分均有显著改善(<0.0001)。多元线性回归发现,术后四周时,未依从药物治疗(>0.40)、鼻腔冲洗(>0.22)、药物和鼻腔冲洗均未依从(>0.40)以及吸烟状态为阳性(>0.11)的患者之间无显著差异。在3个月和24个月的随访中,依从患者与未依从药物治疗、鼻腔冲洗或两者的患者之间的ROE评分无显著差异(>0.13)。
我们的数据是唯一一组考虑了鼻中隔成形术患者对鼻腔冲洗、戒烟和抗菌药物依从性的患者报告结局。对鼻腔冲洗、局部抗菌药物或戒烟的依从性并未影响术后ROE评分。