Comparison of Patient-Reported Outcomes Between Dorsal Preservation and Conventional Dorsal Hump Reduction Rhinoplasty: A Systematic Review and Meta-Analysis.

BACKGROUND

Recently, improvements in dorsal preservation rhinoplasty have been reported to minimize swelling, reduce scarring, and the aesthetic lines of the nasal dorsum.

METHODS

Sourcing studies from six databases, the change in patient-reported scores for cosmetic satisfaction (-C) (using a visual analogue scale [VAS] and the Standardized Cosmesis and Health Nasal Outcomes Survey [SCHNOS]) and nasal obstruction severity (-O) (using a VAS, the SCHNOS, and the Nasal Obstruction Symptom Evaluation [NOSE]) related to the presence of a nasal anatomical deformity were recorded from baseline (before treatment) to post-treatment and compared between an intervention group (dorsal preservation rhinoplasty) and a conventional group (conventional dorsal hump reduction rhinoplasty). The mean difference was chosen to calculate effect sizes of patient-reported outcomes.

RESULTS

Data for meta-analysis were retrieved for six studies with a total of 753 patients. The cosmetic satisfaction of patients was significantly greater in the intervention group versus the conventional group (VAS-C: -0.5215 [-0.9616; -0.0814]/SCHNOS-C: 1.9385 [0.1648-3.7123]). There was no significant difference in nasal obstruction scores between the intervention and conventional groups (VAS-O: -0.1997 [-0.5337; 0.1343]/SCHNOS-O: 0.5204 [-1.0096; 2.0504]/NOSE: -3.7884 [-10.2381; 2.6612]). According to the timing of measurement, the intervention group maintained a better improvement in cosmetic satisfaction (VAS-C and SCHNOS-C) until six months postoperation (early), but there was no significant difference thereafter.

CONCLUSION

Based on the patient-reported cosmetic or functional benefits, although dorsal preservation led to better cosmetic results in the early follow-up period, the results after six months were similar in the two groups. The two techniques led to similar functional improvements in nasal obstruction at one year of follow-up.

LEVEL OF EVIDENCE III

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