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Farahani PK. Application of Tissue Engineering and Biomaterials in Nose Surgery. JPRAS Open 2024; 40:262-272. [PMID: 38708386 PMCID: PMC11067003 DOI: 10.1016/j.jpra.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 11/05/2023] [Indexed: 05/07/2024] Open
Abstract
Surgery of the nose involves a series of operations that are directed at restoring the nasal anatomy and physiology. The extent or degree of reconstruction needed is dependent on the appearance-based requirement of the patients and the procedure exploited for the correction such that nasal airflow is preserved. Standard surgical approach includes the use of autologous tissue or implantation alloplastic bio or synthetic/fabricated construct materials to correct the defects. Over the years, tissue engineering has been proven to be a promising technique for reconstructing tissue and organ defects, including the nose. Recently, there has been keen interest in fabricating new tissues and organ scaffolds using 3D printing technology with good control over the micro-architecture and excellent interior architecture suitable for cell seeding. Unviability of the tissue and harvest-associated complications have increased the need for the investigation of tissue engineering based methods for nasal reconstruction using biomaterials, stem cells, and growth factors combined with 3D bioprinting. However, there are only a handful of studies vis-à-vis the application of cartilage tissue engineering, stem cells, and growth factors for the purpose. This review provides highlights about the available studies based on the application of stem cells, biomaterials, and growth factors for nasal reconstruction surgery, as there is limited recent information on the use of these entities in nasal surgeries.
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Nirunrungrueng P, Virarat P, Techalertpaisarn P, Ungvijanpunya N. Nasolabial morphological changes in patients with unilateral cleft lip and palate using a Korat-modified nasoalveolar moulding appliance with primary correction. Orthod Craniofac Res 2024; 27 Suppl 1:80-89. [PMID: 38305564 DOI: 10.1111/ocr.12765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The objective of this study is to measure the morphological changes of the nose and lip in patients with unilateral cleft lip and palate before and after cheiloplasty with primary rhinoplasty (primary correction) in conjunction with Korat-NAM usage. DESIGN Longitudinal cohort study. SETTING Cleft Center Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand. SUBJECTS Twenty-six patients with unilateral cleft lip and palate. INTERVENTIONS Control group: only active obturator before primary correction. Experimental group: an active obturator and Korat-NAM I before primary correction. A customized endotracheal tube was retained in the nostril for 3 weeks before switching to Korat-NAM II for 1 year. MAIN OUTCOME MEASURES Six measurements comprising nostril rim length, nostril height, nostril sill width, columella angle, vertical lip height, and horizontal lip length were measured from the patients' photographs. All measurements, except the columella angle, were reported as the cleft side/non-cleft side value ratio. Measurements were taken at the initial appointment, immediately before, 3 weeks after, and 1 year after primary correction. RESULTS Nostril rim length ratio, nostril height ratio, nostril sill width ratio, columella angle on the cleft side, and vertical lip height ratio were improved using Korat-NAM before and 3 weeks after primary correction. Nostril rim length and height ratios were significantly better than the control group. CONCLUSIONS Korat-NAM improved nose and lip morphology before primary correction. An overcorrection improved the nose and lip morphology on the cleft side. The nostril rim length and vertical lip height on the cleft side also improved with Korat-NAM II 1 year after primary correction.
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Affiliation(s)
| | - Pongjai Virarat
- Cleft Center Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | | | - Nicha Ungvijanpunya
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Lyrio T, Ferreira MG, Torres PG, Santos M, Tamanqueira P. "Supratip Cross Flap: Reshaping the Nasal Tip and Improving the Nasal Vault Function.". Facial Plast Surg Aesthet Med 2024. [PMID: 38708628 DOI: 10.1089/fpsam.2024.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
The authors propose a novel flap for rhinoplasty: the supratip cross flap (SCF). It is a simple and effective method for avoiding and correcting alar contour deformities and external nasal valve (ENV) issues in rhinoplasty without grafts. In addition to its benefit for supratip break, the flap also allows a smooth and natural transition between the nasal dorsum and the nasal tip complex.
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Affiliation(s)
- Tiago Lyrio
- Plastic Surgeon at Private Practice (V Clinic), Rio de Janeiro, Brazil
| | - Miguel Gonçalves Ferreira
- Centro Hospitalar Universitário de Santo António, Otolaryngology, Head and Neck Surgery Department, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | | | - Mariline Santos
- Centro Hospitalar Universitário de Santo António, Otolaryngology, Head and Neck Surgery Department, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Paula Tamanqueira
- Plastic Surgeon at Private Practice (V Clinic), Rio de Janeiro, Brazil
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Hohenberger R, Endres P, Salzmann I, Plinkert PK, Wallner F, Baumann I, Alt J, Riedel F, Lippert BM, Bulut OC. Quality of Life and Screening on Body Dysmorphic Disorder, Depression, Anxiety in Septo rhinoplasty. Laryngoscope 2024; 134:2187-2193. [PMID: 38050954 DOI: 10.1002/lary.31212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Septorhinoplasty (SRPL) can improve quality of life (QoL) in functional and aesthetical aspects of the nose. A key factor compromising postoperative satisfaction is symptoms of body dysmorphic disorder (BDD), defined by excessive concerns and distress over slight or imagined physical defects. Although a high prevalence of BDD in SRPL patients is evident, the effect of positive screening on BDD and other psychiatric disorders is understudied. It was hypothesized that patients screening positive for BDD, depression or anxiety do not show increased postoperative QoL. METHODS A multicenter, prospective study including 259 patients. For psychiatric evaluation, the BDD concern questionnaire-aesthetic version and the Hospital Anxiety and Depression Scale were used; for disease-specific QoL the Rhinoplasty Outcomes Evaluation (ROE) and the Functional Rhinoplasty Outcome Inventory (FROI-17). RESULTS In preoperative evaluation, 32.5% had a positive screening for BDD, 42.2% for increased anxiety, and 32.9% for depression. Mean QoL improved in the whole cohort (FROI total score: 54.4 ± 21.8 to 32.8 ± 23.7 and ROE: 32.3 ± 15.6 to 69.8 ± 23.1, both p < 0.001). Patients screening positive for BDD, depression or anxiety did show an increased postoperative QoL, but to a significantly lower degree and with lower pre- and postoperative QoL levels. CONCLUSIONS SRPL patients show a high prevalence of BDD symptoms, elevated anxiety, and depression. These subgroups show lower QoL levels and an impaired QoL increase after surgery. Rhinoplasty surgeons must be aware of the disorders and their symptoms, discuss potential concerns with the patients, and potentially refer them to a specialist. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2187-2193, 2024.
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Affiliation(s)
- Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Philipp Endres
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Irina Salzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Wallner
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ingo Baumann
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Janes Alt
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | | | - Burkard M Lippert
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | - Olcay Cem Bulut
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
- HNO-Zentrum Rhein-Neckar, Mannheim, Germany
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Suh MK, Won JY, Baek JH. Paradigm Shift in Rhinoplasty with Virtual 3D Surgery Software and 3D Printing Technology. Arch Plast Surg 2024; 51:268-274. [PMID: 38737849 PMCID: PMC11081721 DOI: 10.1055/a-2272-5273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 02/01/2024] [Indexed: 05/14/2024] Open
Abstract
Most Asians have a nose with a short columella and a low dorsum; augmentation rhinoplasty using implants is commonly performed in Asian countries to achieve a taller and more well-defined nasal dorsum. However, the current knowledge is insufficient to fully understand the various subjective desires of patients, reflect on them during surgery, or to objectively analyze the results after surgery. Advances in digital imaging technologies, such as 3D printing and 3D scanning, have transformed the medical system from hospital-centric to patient-centric throughout the medical field. In this study, we applied these techniques to rhinoplasty. First, we used virtual 3D plastic surgery software to enable surgical planning through objectified numerical calculations based on the visualized data of the patient's medical images rather than simple virtual plastic surgery. Second, the customized nasal implant was manufactured by reflecting the patient's anatomical shape and virtual 3D plastic surgery data. Taken together, we describe the surgical results of applying these rhinoplasty solutions in four patients. Our experience indicates that high fidelity and patient satisfaction can be achieved by applying these techniques.
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Affiliation(s)
- Man Koon Suh
- JW Plastic Surgery Center, Gangnam-gu, Seoul, Republic of Korea
| | - Joo-Yun Won
- Clinical and Translational Research Institute, Anymedi Inc., Seoul, South Korea
| | - Jung-Hwan Baek
- H Plastic Surgery Clinic 5F, Seocho-gu, Seoul, Republic of Korea
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Yang J, Wu X, Nie J. Comparative study between remifentanil (or fentanyl) and dexmedetomidine for the analgesia of rhinoplasty: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2024; 103:e37020. [PMID: 38640315 PMCID: PMC11029972 DOI: 10.1097/md.0000000000037020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/08/2023] [Accepted: 01/02/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Remifentanil (or fentanyl) and dexmedetomidine may have some potential to improve the analgesia of rhinoplasty, and this meta-analysis aims to compare their efficacy for the analgesia of rhinoplasty. METHODS PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the analgesic effect of remifentanil (or fentanyl) versus dexmedetomidine for rhinoplasty. RESULTS Four RCTs were finally included in the meta-analysis. In patients undergoing rhinoplasty, remifentanil (or fentanyl) infusion and dexmedetomidine infusion resulted in similar good patient satisfaction (odd ratio [OR] = 2.71; 95% confidence interval [CI] = 0.63 to 11.64; P = .18), good surgeon satisfaction (OR = 1.68; 95% CI = 0.02 to 181.40; P = .83), extubation time (mean difference [MD] = 7.56; 95% CI = -11.00 to 26.12; P = .42), recovery time (MD = -2.25; 95% CI = -23.41 to 18.91; P = .83), additional analgesic requirement (OR = 0.16; 95% CI = 0 to 8.65; P = .37) and adverse events (OR = 8.50; 95% CI = 0.47 to 153.30; P = .15). CONCLUSIONS Remifentanil (or fentanyl) and dexmedetomidine may have comparable analgesia for patients undergoing rhinoplasty.
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Affiliation(s)
- Jiao Yang
- Department of Anesthesia Operation, The First People’s Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Xuejun Wu
- Department of Anesthesia Operation, The First People’s Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Jinfeng Nie
- Department of Anesthesia Operation, The First People’s Hospital of Chongqing Liangjiang New Area, Chongqing, China
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Hemmerich C, Corcoran A, Johnson AL, Wilson A, Orris O, Arellanes R, Vassar M. Reporting of Complications in Rhinoplasty Randomized Controlled Trials: An Analysis Using the CONSORT Extension for Harms Checklist. Otolaryngol Head Neck Surg 2024. [PMID: 38613190 DOI: 10.1002/ohn.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE This study aimed to assess the completeness of adverse event (AE) reporting in randomized control trials (RCTs) focused on rhinoplasty, using the Consolidated Standards for Reporting (CONSORT) Extension for Harms checklist. STUDY DESIGN A cross-sectional design was employed to review RCTs related to rhinoplasty published between January 1, 2005, and January 28, 2022. SETTING The study analyzed clinical trials on rhinoplasty retrieved from PubMed. METHODS We performed a comprehension search on PubMed, blind and duplicate screening, and data extraction. Adherence to the 18 recommendations of the CONSORT Extension for Harms was evaluated, with 1 point assigned for each adhered item. Percent adherence was calculated based on the 18 points, taking into account the multiple subcategories within some recommendations. Descriptive statistics were used to summarize adherence-including frequencies, percentages, and 95% confidence intervals. RESULTS Our search returned 240 articles, of which 56 met inclusion criteria. No RCTs adhered to all 18 CONSORT Extension for Harms items. Twenty-six (26/56, 46.4%) adhered to ≥50% of the items, and 30 (30/56, 53.6%) adhered to ≥33.3% of the items. Seven (7/56, 12.5%) RCTs adhered to no items. Across all RCTs, the average number of CONSORT-Harms items adhered to was 7.2 (7.2/18, 40.0%). The most adhered to item was item 10. Discussion balanced with regard to efficacy and AEs (80.4%, [70.0-90.8]). CONCLUSION This study highlights the inadequacy of AE reporting in rhinoplasty RCTs according to CONSORT-Harms guidelines. Urgent efforts are required to bridge this reporting gap and enhance transparency in surgical research, ultimately safeguarding patient well-being.
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Affiliation(s)
- Christian Hemmerich
- Department of Medical Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Adam Corcoran
- Department of Otolaryngology, Mclaren Oakland, Detroit, Michigan, USA
| | - Austin L Johnson
- Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Andrew Wilson
- Department of Medical Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Olivia Orris
- Department of Medical Research, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Russell Arellanes
- Department of Otolaryngology, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Department of Medical Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Bhethanabotla RM, Ledgister K, Soriano IS, O'Sullivan P, Bigelow E, Knott PD, Park AM. Ergonomic Assessment of Septo rhinoplasty Maneuvers During Simulated Pregnancy. OTO Open 2024; 8:e126. [PMID: 38577238 PMCID: PMC10988238 DOI: 10.1002/oto2.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
Objective Women represent an increasing proportion of the otolaryngology workforce. Work-related musculoskeletal disorders (WRMSD) are a little-studied yet important impediment to career completion. Scant attention has been directed to study the impact of pregnancy on surgeon posture and ergonomics. We piloted the use of a pregnancy simulation suit (Empathy Belly) to assess the risk of ergonomic compromise when performing open septorhinoplasty. Study Design Surgical simulation. Setting Single session, training simulation lab at academic medical center. Methods Medical students and surgical residents performed the initial steps of a rhinoplasty procedure without and with a pregnancy simulation suit and were filmed with an artificial intelligence-based video analysis app from Kinetica Labs that calculates joint angles and categorizes the ergonomic risk factors. Still images from videos were taken and analyzed using validated posture-based analysis rubrics. Participants were asked to complete a qualitative questionnaire after the session. Results Twelve medical students and surgical residents participated in the study. Posture-based analysis indicated increased ergonomics risk factors among trainees when performing a rhinoplasty while wearing the pregnancy suit. Video analysis indicated trends of worsening back angle and shoulder postures. Trainees reported experiencing pain in the neck, suprapubic area, and lower back. They acknowledged the importance of ergonomics in otolaryngology and desired further education about workplace injury risk mitigation. Conclusion Pregnancy impacts the ergonomics of performing septorhinoplasty and further investigation is required into interventions to reduce risk of WRMSDs.
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Affiliation(s)
- Rohith M. Bhethanabotla
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Kaye Ledgister
- Department of Environment, Health, and SafetyUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Ian S. Soriano
- Department of SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Patricia O'Sullivan
- Department of SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Elaine Bigelow
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Philip Daniel Knott
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
| | - Andrea M. Park
- Department of Otolaryngology–Head and Neck SurgeryUniversity of California‐San FranciscoSan FranciscoCaliforniaUSA
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Brownlee BP, Hassoun A, Parikh A, Chen XS, Zhao D, Mims MM. Cadaveric Assessment of the Butterfly Graft in Rhinoplasty. Laryngoscope 2024; 134:1638-1641. [PMID: 37837400 DOI: 10.1002/lary.31069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION The rhinoplasty butterfly graft is used to improve the internal nasal valve (INV), but post-operative visibility remains a concern. Intraoperative techniques have developed to thin the graft with unknown effect on functionality. OBJECTIVES Improve understanding of how to modify the aesthetics of the butterfly graft without impacting patient outcomes. Determine how graft contouring affects its biomechanical properties. METHODS Cadaveric cartilage grafts were used to examine the biomechanics in its native state and with progressive thinning. The force needed to stabilize the INV in an unaltered state and the resistance force provided by native (original), partially thinned, and fully thinned cartilage grafts were recorded. RESULTS The mean thickness of grafts in their natural state was 1.64 mm, median 1.50 mm (SD 0.64 mm). The fully-thinned mean was 0.84 mm, median 0.8 mm (SD 0.18 mm). The mean force (N) of the native graft was 0.74 N and 0.60 N for fully thin (p = 0.016, 95%). The mean force (N) needed to stabilize the INV was 0.15 N (right) and 0.19 N (left). CONCLUSION Butterfly grafts can be thinned by approximately 50% of their original thickness and retain the strength to stabilize the INV. LEVEL OF EVIDENCE NA Laryngoscope, 134:1638-1641, 2024.
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Affiliation(s)
- Benjamin P Brownlee
- Department of Otolaryngology-Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
| | - Adam Hassoun
- Department of Otolaryngology-Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
| | - Aniruddha Parikh
- Department of Otolaryngology-Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
| | - Xi Sophia Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
| | - Daniel Zhao
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
| | - Mark M Mims
- Department of Otolaryngology-Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, U.S.A
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Chen Y, Wang X, Wu J, Zeng W, Yang K, Sun Y, Xiong X, Meng X, Li W, Yi Z, Fang B. A New Algorithm for Secondary Repair of Unilateral Cleft Lip Nasal Deformity. Laryngoscope 2024; 134:1648-1655. [PMID: 37991199 DOI: 10.1002/lary.31167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/14/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Following primary surgery for unilateral cleft lip palate (UCLP), cleft lip nasal deformities (CLNDs) (nasal asymmetry, collapsed nasal alae, and a widened alar base) are generally inevitable and often require secondary rhinoplasty. However, reconstructing a cleft nose with an alar tissue deficiency remains challenging for rhinoplasty surgeons. METHODS The manifestations of common deformities are described herein, and a secondary rhinoplasty technique for unilateral CLNDs using a nasolabial flap (NLF) has been proposed for patients with alar tissue deficiency. Secondary rhinoplasties were performed in 12 patients with unilateral CLNDs between 2020 and 2021 using a NLF. Photogrammetric measurements were performed preoperatively and postoperatively. A total of 12 flaps were successfully transferred. Ten patients were followed up for >1 year. RESULTS Significant postoperative decreases in nasal alar width were measured in both the base view (p < 0.050) and the frontal view (p < 0.050). Despite the additional facial scars that occurred in some cases, all patients were satisfied with the aesthetic effects. CONCLUSIONS The NLF achieved satisfactory results in secondary rhinoplasty of unilateral CLND for patients with nasal tissue deficiencies in whom the surgeon weighed the potential benefits over postoperative scarring. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1648-1655, 2024.
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Affiliation(s)
- Yunzhu Chen
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Jingjing Wu
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Weiliang Zeng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Kai Yang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Zhongjie Yi
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
| | - Bairong Fang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, PR China
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Torbey A, Mdawr E, Kahal F, Rmman M, Omar A, Alzabibi MA, Kadri SA, Tawahri E, Nahas LD. Anthropometry of the nose pre- and post-photogrammetric adjustments in a sample of Syrian medical students. A cross-sectional study. Health Sci Rep 2024; 7:e2062. [PMID: 38650727 PMCID: PMC11033293 DOI: 10.1002/hsr2.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/23/2024] [Accepted: 03/31/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims The individual's perceived beauty, sense of identity, and general well-being are all influenced by the social implications of the esthetics of their facial appearance. One of the major indicators of one's facial beauty is anthropometric proportions. This study was conducted to measure and evaluate the anthropometric proportions in a Syrian population, and to determine their desired nasal shape. Methods A cross-sectional study was conducted on Syrian university students. Lateral and frontal pictures of the participants were taken using Canon EOS 250D from a standard distance of 100 cm. These pictures were analyzed, then nasal measurements were adjusted according to the participants' desire using Adobe Photoshop 2020. All anthropometric measurements were conducted on AutoCAD® 2019 software before and after the adjustments. Data was analyzed using the SPSS-25 using paired samples T test to compare the means. Results The study included 53 females and 47 males. The mean age was 22.25. The mean unadjusted nasofrontal angle, nasolabial angle, nasomental angle, nasofacial angle, nasal index, Byrd and Hobar ratio, and Powell-modified Baum ratio were 141.80, 102.18, 129.21, 34.60, 71.71, 0.62, and 3.08 in the rhinoplasty-negative participants, and 145.89, 102.03, 130.20, 32.44, 67.96, 0.64, and 3.06 in the rhinoplasty-positive participants, respectively. While the mean of the adjusted previously mentioned angles were 144.59, 106.32, 131.19, 31.15, 62.91, 0.60, and 3.19 in the rhinoplasty-negative participants, and 146.31, 102, 130.20, 31, 62.55, 0.62, and 3.08 in the rhinoplasty-positive participants, respectively. Conclusion In contrast to other populations, our study concluded that Syrians had unique anthropometric measurements and facial esthetics preferences. Moreover, the local plastic surgeons were able to identify most of the preferred nasal measurements for rhinoplasty in this ethnic group. It is advisable to use photogrammetry before rhinoplasty to identify the preferred nasal measurements of each individual to ensure the patient's satisfaction with the outcome of the surgery. Level of Evidence Level IV, cross-sectional study.
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Affiliation(s)
- André Torbey
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Elian Mdawr
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Fares Kahal
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Mohammad Rmman
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Abdullah Omar
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | | | - Saeed A. Kadri
- Faculty of MedicineSyrian Private UniversityDamascusSyria
| | - Enaam Tawahri
- Faculty of MedicineSyrian Private UniversityDamascusSyria
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12
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Pozzi M, Susini P, di Seclì D, Schettino M, Grimaldi L, Cuomo R, Roxo CW. Augmentation Rhinoplasty and Centrofacial Lipofilling: Our Experience (ARCL). J Clin Med 2024; 13:1965. [PMID: 38610730 PMCID: PMC11012668 DOI: 10.3390/jcm13071965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/02/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Introduction: Augmentation rhinoplasty traditionally represents a serious challenge for plastic surgeons. The association with centrofacial lipofilling is a great approach to achieve harmonious, aesthetic results. The aim of this article is to describe our personal association between Augmentation Rhinoplasty and Centrofacial Lipofilling (ARCL) in non-Caucasian patients. Materials and Methods: In this study, we retrospectively reviewed patients treated with ARCL at our institution between January 2019 and December 2023. We described our personal approach and technique. At a minimum follow-up time of one year, post-operative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape and contour of the nose, and facial harmony and rejuvenation; finally, patients' satisfaction was investigated according to the ROE questionnaire and the modified S-GAIS. Results: A total of 307 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image and facial harmony, as the mean postoperative ROE and S-GAIS score show. None of the grafts extruded or collapsed. Wounds healed without reported major infection. Conclusions: This study has demonstrated that ARCL is a safe approach that contributes to improve functional and aesthetic outcomes, has a high patient satisfaction rate, and limited post-operative complications.
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Affiliation(s)
- Mirco Pozzi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (P.S.); (D.d.S.); (L.G.); (R.C.)
| | - Pietro Susini
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (P.S.); (D.d.S.); (L.G.); (R.C.)
| | - Davide di Seclì
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (P.S.); (D.d.S.); (L.G.); (R.C.)
| | - Michela Schettino
- Unit of Plastic and Reconstructive Surgery, CHIREC de Braine L’Alleud Hospital, 1410 Brussels, Belgium;
| | - Luca Grimaldi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (P.S.); (D.d.S.); (L.G.); (R.C.)
| | - Roberto Cuomo
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (P.S.); (D.d.S.); (L.G.); (R.C.)
| | - Carlos Weck Roxo
- Instituto Carlos Roxo, Avenida Ayrton Senna n°1850, Rio de Janeiro 22775-003, RJ, Brazil;
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13
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Bulut OC, Lippert BM, Riedel F, Plath M, Hohenberger R. Quality of Life Improvement in Concurrent Septo rhinoplasty and Endoscopic Sinus Surgery. Laryngoscope 2024; 134:1239-1245. [PMID: 37706653 DOI: 10.1002/lary.31054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES Septorhinoplasty (SRPL) and functional endoscopic sinus surgery (FESS) are two frequently performed surgeries to improve quality of life (QoL) in patients with nasal symptoms. It has been demonstrated as a safe combination regarding complication rates, but patient satisfaction in concurrent surgery has not been adequately studied yet. METHODS Patients undergoing sole FESS due to chronic rhinosinusitis (n = 57), sole SRPL (n = 148), and concurrent surgery (n = 62) were prospectively evaluated for their disease-specific QoL before and one year after surgery. Each procedure was performed by the same surgeon (OCB). For SRPL, the patient-reported outcome measures Rhinoplasty Outcomes Evaluation (ROE) and Functional Rhinoplasty Outcome Inventory (FROI-17) were utilized, and for chronic rhinosinusitis, the Sino-Nasal Outcome Test-22 (SNOT22). RESULTS All three groups showed significant improvement in the postoperative QoL measurements (all p < 0.01). The postoperative improvements were slightly smaller in the concurrent surgery group compared with the single surgery groups measured with ROE (combined: +55.2 ± 9.3, single: +58.8 ± 9.8, p = 0.02), FROI total score (combined: +47.6 ± 5.2, single: +49 ± 5.4; p = 0.08) and SNOT22 (combined: +33.1 ± 6.7, single +34.5 ± 7, p = 0.26). CONCLUSIONS SRPL, FESS, and combined surgery improve disease-specific QoL. When applicable, surgeons may offer the benefits of a combined procedure without compromising the QoL gain. LEVEL OF EVIDENCE 3 Laryngoscope, 134:1239-1245, 2024.
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Affiliation(s)
- Olcay Cem Bulut
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
- HNO-Zentrum Rhein-Neckar, Mannheim, Germany
| | - Burkard M Lippert
- Department of Otorhinolaryngology, Head and Neck Surgery, SLK Kliniken, Heilbronn, Germany
| | | | - Michaela Plath
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ralph Hohenberger
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany
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14
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Derakhshan A, Gadkaree SK, Barbarite ER, Lindeborg MM, Bhama PK, Shaye DA. Quantifying Facial Distortion in Modern Digital Photography. Laryngoscope 2024; 134:1234-1238. [PMID: 37543968 DOI: 10.1002/lary.30935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/12/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Advancements in digital cameras and the advent of smartphones have magnified the importance of clinical photography in facial plastic surgery. Here, we aim to examine the effect of different camera types, focal lengths, and distances from subjects on facial distortion. METHODS Twelve subjects underwent a series of frontal photographs using a smartphone camera and a full-frame digital single-lens reflex camera. Photos were captured at six distances from the subject. Seven focal lengths were used at each distance for the full-frame camera. Measurements of facial landmarks were made for each photo, with those made at 60 inches using the full-frame camera considered the gold standard and used for comparison. RESULTS Distortion of facial features using the full-frame camera occurred when photos were captured 8 inches away using short focal lengths. A 12%-19% increase in vertical stretching of the midface occurred when using focal lengths of 24, 35, and 50 mm (p < 0.05 for all). The same features were distorted when a smartphone camera was used at 8 inches (18% increase, p < 0.01) and 12 inches (12% increase, p < 0.03). CONCLUSIONS Distortion of midfacial features using both smartphones and full-frame cameras occurs with short, 'selfie' distances between the camera and subject. LEVEL OF EVIDENCE 2 Laryngoscope, 134:1234-1238, 2024.
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Affiliation(s)
- Adeeb Derakhshan
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, California, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Shekhar K Gadkaree
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Eric R Barbarite
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - Michael M Lindeborg
- Department of Otolaryngology Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Prabhat K Bhama
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Providence Regional Medical Center, Everett, Washington, U.S.A
| | - David A Shaye
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
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15
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Alhusayni MA, Alzahrani AA, Alhomaidi FM, Alotaibi RN, Abu Rukbah LK, Alotaibi GF, Alnofaie MF. Interest in Rhinoplasty and Awareness of Postoperative Complications Among Female High School Students in Taif, Saudi Arabia. Cureus 2024; 16:e56741. [PMID: 38650772 PMCID: PMC11034891 DOI: 10.7759/cureus.56741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Background and objective There has been a significant increase in rhinoplasty procedures in Saudi Arabia recently. Cultural factors, societal pressure, and a desire for beauty and self-improvement contribute to the growing interest in cosmetic procedures among the Saudi population. However, limited research has been conducted specifically focusing on the interest in rhinoplasty and the awareness of postoperative complications among female high school students. This study aimed to investigate the interest in rhinoplasty and awareness of postoperative complications among female high school students in Taif, Saudi Arabia. Methodology A cross-sectional observational study was conducted among female high school students through January and February 2024 using a validated questionnaire comprising sociodemographic characteristics, attitudes toward rhinoplasty, and the females' familiarity with the postoperative complications of rhinoplasty. Results The study was conducted among 737 female high school students. About half of the females (N = 376, 51%) were 18 years old, and the other half were under 18 years old (N = 361, 49%). Out of the total females, only 19 (2.6%) underwent cosmetic surgery, with 6 (60%) opting for rhinoplasty. The study found that 152 (20.6%) females were interested in rhinoplasty, and about a quarter of them (N = 99, 13.4%) did not feel happy about their noses. The most common rhinoplasty complications reported by the respondents were a mismatch of the new nose with the rest of the face (N = 471, 63.9%), headache (N = 459, 62.3%), breathing disorders (N = 458, 62.1%), dissatisfaction with the new nose (N = 437, 59.3%), and nose blockage (N = 427, 57.9%). It was found that interest in rhinoplasty was significantly more common among participants having relatives or friends who underwent rhinoplasty than others (N = 51, 25.8% vs. N = 85, 17.2%, respectively; P = 0.010). Moreover, it was revealed that interest in rhinoplasty was significantly more common among participants who were not happy with their nose (N = 78, 78.8%) than those who were happy with their nose (N = 41, 8.3%) and those who did not care (N = 33, 22.9%) (P < 0.001). Conclusions The study revealed that a significant percentage of participants expressed interest in rhinoplasty, indicating a desire for nose reshaping. Counseling services should be available to support students in developing positive body image and self-acceptance. Furthermore, it is important to establish guidelines for media and advertising to guarantee accurate information from surgeons and psychiatrists, ensuring that the public receives balanced and reliable information.
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16
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Shekarriz P, Hosseini F, Shojaee P. Ultrasound assessment of the nose vasculature: A review of the common method of non-surgical filler-based rhinoplasty. J Cosmet Dermatol 2024; 23:731-736. [PMID: 37846655 DOI: 10.1111/jocd.16037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND With the increasing use of dermal injectable fillers in aesthetic medicine, the popularity of non-surgical filler-based rhinoplasty (NSR) is also growing. While performing this procedure might result in certain vascular complications, injecting deep into the midline of the nose is commonly considered the safest method for blind primary NSR. AIMS In this study, we challenged the common NSR method with a Doppler ultrasound study of the nose. PATIENTS/METHODS The vascular pattern of the common zones of the NSR procedure (radix and nasal tip) of 21 Iranian women were investigated by using a 14 MHz Doppler handheld ultrasound device (Silarious L14PS). Participants had never undergone any procedure on their nose. We focused on the depth of midline vessels in the radix and nasal tip. The radix was studied sagittally and horizontally, and the nasal tip was examined axially by ultrasound. RESULTS In the radix of eight cases (38%), at least one vessel was observed at midline, and all were superficial. In the nose tip of 18 cases (86%), at least one vessel was observed at midline, and 9 out of these 18 vessels (50%) were deep. As a result, conducting NSR by the common method in our study population was relatively safe in the radix, but there was an increased likelihood of vascular events in the tip. CONCLUSION Our research results show that while the common method of the NSR may carry a high risk of vascular events, the safety of this procedure could be enhanced by using ultrasound for planning and conducting a tailored treatment.
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17
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Heidarizadeh M, Sarrafzadeh A, Mohebiniya M, Jadidi S. Accidental finding prior to rhinoplasty: Rhinolith-A rare case report. Clin Case Rep 2024; 12:e8679. [PMID: 38510232 PMCID: PMC10950789 DOI: 10.1002/ccr3.8679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
Through this case report, we review a rare radiographic finding within the nasal cavity and its histopathological findings in order to emphasize the importance of familiarizing oneself with all radiographic findings, regardless of their rarity.
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Affiliation(s)
- Mehdi Heidarizadeh
- Department of Oral and Maxillofacial Surgery, School of DentistryArak University of Medical SciencesArakIran
| | - Arash Sarrafzadeh
- Department of Oral and Maxillofacial Surgery, School of DentistryArak University of Medical SciencesArakIran
| | - Maryam Mohebiniya
- Department of Oral and Maxillofacial Radiology, School of DentistryArak University of Medical SciencesArakIran
| | - Soheila Jadidi
- School of DentistryArak University of Medical SciencesArakIran
- Student Research CommitteeArak University of Medical SciencesArakIran
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18
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Song L, Liu X. Evaluating the therapeutic and reconstructive efficacy of flap transplantation techniques in managing nasal tissue deficiency resulting from post- rhinoplasty surgical infections. Int Wound J 2024; 21:e14566. [PMID: 38379268 PMCID: PMC10809024 DOI: 10.1111/iwj.14566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 02/22/2024] Open
Abstract
Rhinoplasty is a frequently performed aesthetic surgery with a high procedural volume. Despite the operational ease and safety profile of biocompatible materials such as silicone and inflatable prosthetics, postoperative complications like surgical site infections can lead to significant clinical challenges. These complications necessitate effective therapeutic and reconstructive interventions. This study aims to evaluate the efficacy of different flap transplantation techniques for early treatment of post-rhinoplasty nasal tissue deficiencies. A retrospective study was conducted from May 2018 to May 2023, involving 38 patients divided into a control group receiving standard anti-infective treatment and an observation group undergoing early flap grafting procedures. Efficacy was evaluated using objective metrics-namely, nasal appearance, function and flap condition-each assessed through a 10-point scoring system, and subjective metrics such as patient satisfaction gauged through self-administered questionnaires. Statistical analyses were performed using SPSS version 27.0. Both groups were statistically comparable in terms of demographics such as age, marital status and educational background. The observation group displayed significantly improved outcomes in terms of nasal aesthetics (mean score 7.92 ± 1.00), nasal function (mean score 8.47 ± 0.51) and flap condition (mean score 7.89 ± 1.12) compared to the control group. Flap transplantation techniques demonstrated superior therapeutic and reconstructive efficacy in the management of nasal tissue deficiencies arising from post-rhinoplasty surgical infections. These findings contribute to evidence-based recommendations for optimal clinical practice.
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Affiliation(s)
- Lei Song
- Cosmetic ClinicBeijing Scarlette Medical ClinicBeijingChina
| | - Xiuyan Liu
- Cosmetic ClinicBeijing Scarlette Medical ClinicBeijingChina
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19
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Park AC, Hutchison DM, Prasad KR, Hernandez K, Dilley KK, Gedeon DN, Wong BJF. Costal Cartilage Considerations: Novel Use of Handheld Ultrasound Device in Rhinoplasty. Laryngoscope 2024; 134:651-653. [PMID: 37300433 DOI: 10.1002/lary.30760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 06/12/2023]
Abstract
Handheld ultrasound devices can be used in revision rhinoplasty to evaluate the calcification of costal rib cartilage that is to be harvested for grafting. This article provides instructions on how to perform this technique. Laryngoscope, 134:651-653, 2024.
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Affiliation(s)
- Asher C Park
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Dana M Hutchison
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Karthik R Prasad
- Department of Otolaryngology, Head and Neck Surgery, Yale University, New Haven, Connecticut, USA
| | - Kelly Hernandez
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Katelyn K Dilley
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - David N Gedeon
- Department of Radiology, University of California Irvine, Orange, California, USA
| | - Brian J-F Wong
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
- Department of Otolaryngology, Head and Neck Surgery, University of California Irvine, Orange, California, USA
- Department of Biomedical Engineering, Samueli School of Engineering, University of California Irvine, Irvine, California, USA
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20
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Mandava S, Oyer SL, Park SS. A quantitative analysis of Twitter ("X") trends in the discussion of rhinoplasty. Laryngoscope Investig Otolaryngol 2024; 9:e1227. [PMID: 38384363 PMCID: PMC10880128 DOI: 10.1002/lio2.1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/04/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Rhinoplasty is one of the most common cosmetic surgical procedures performed globally. Twitter, also known as "X," is used by both patients and physicians and has been studied as a useful tool for analyzing trends in healthcare. The public social media discourse of rhinoplasty has not been previously reported in the field of otolaryngology. The goal of this study was to characterize the most common user type, sentiment, and temporal trends in the discussion of rhinoplasty on Twitter to guide facial plastic surgeons in their clinical and social media practices. Methods A total of 1,427,015 tweets published from 2015 to 2020 containing the keywords "rhinoplasty" or "nose job" were extracted using Twitter Academic API. Tweets were standardized and filtered for spam and duplication. Natural language processing (NLP) algorithms and data visualization techniques were applied to characterize tweets. Results Significantly more "nose job" tweets (80.8%) were published compared with "rhinoplasty" (19.2%). Annual tweet frequency increased over the 5 years, with "rhinoplasty" tweets peaking in January and "nose job" tweets peaking in the summer and winter months. Most "rhinoplasty" tweets were linked to a surgeon or medical practice source, while most "nose job" tweets were from isolated laypersons. While discussion was positive in sentiment overall (M = +0.08), "nose job" tweets had lower average sentiment scores (P < .001) and over twice the proportion of negative tweets. The top 20 most prolific accounts contributed to 14,758 (10.6%) of total "rhinoplasty" tweets. Exactly 90% (18/20) of those accounts linked to non-academic surgeons compared with 10% (2/20) linked to academic surgeons. Conclusions Rhinoplasty-related posts on Twitter were cumulatively positive in sentiment and tweet volume is steadily increasing over time, especially during popular holiday months. The search term "nose job" yields significantly more results than "rhinoplasty," and is the preferred term of non-healthcare users. We found a large digital contribution from surgeons and medical practices, particularly in the non-academic and private practice sector, utilizing Twitter for promotional purposes.
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Affiliation(s)
- Shreya Mandava
- School of MedicineUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Samuel L. Oyer
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Stephen S. Park
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of VirginiaCharlottesvilleVirginiaUSA
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Abstract
The anatomic subunit approximation approach to unilateral cleft lip repair was developed over 20 years ago. While the underlying principles of the repair are unchanged, its description has been simplified, additional landmarks and creases have been added, and objective analysis of perioperative changes have provided better clarity regarding goals and desired alterations. We review recent insights regarding the deformity; describe the repair in a simplified manner; and link a stepwise approach to foundation-based primary rhinoplasty as a part of the avenue to creating nasolabial balance and harmony.
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Affiliation(s)
- Raymond W. Tse
- University of Washington, Seattle, WA, USA
- Seattle Children’s Hospital, Seattle, WA, USA
| | - David M. Fisher
- University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
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22
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陈 明, 郭 宗, 于 冰. [Effectiveness of comprehensive rhinoplasty on secondary nasal deformity with saddle nasal deformity after cleft lip surgery]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2024; 38:56-61. [PMID: 38225842 PMCID: PMC10796230 DOI: 10.7507/1002-1892.202305030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/04/2023] [Indexed: 01/17/2024]
Abstract
Objective To investigate the effectiveness of comprehensive rhinoplasty with autogenous costal cartilage grafting and prosthesis augmentation rhinoplasty in the treatment of secondary nasal deformity with saddle nasal deformity after cleft lip surgery. Methods The clinical data of 96 patients with secondary nasal deformity with saddle nasal deformity after cleft lip surgery between September 2008 and January 2019 were retrospectively analyzed. There were 17 males and 79 females with an average age of 25.6 years (range, 17-38 years). Autogenous costal cartilage grafts were used to construct stable nasal tip framework and enhance the strength of alar cartilage. Nasal dorsum prostheses (39 cases of bulge, 45 cases of silicone prosthesis) or autogenous costal cartilage (12 cases) were used for comprehensive rhinoplasty. Visual analogue scale (VAS) score was used to evaluate the postoperative satisfaction subjectively, and nasal alar height symmetry index, nasal alar width symmetry index, nasal dorsum central axis deviation angle, and nasal columella deviation angle were calculated to evaluate objectively before and after operation. Results All patients were followed up 6 months to 8 years, with an average of 13.4 months. Nasal septal hematoma occurred in 3 patients after operation, which was improved after local aspiration and nasal pressure packing. Two cases had mild deformation of the rib cartilage graft of the nasal dorsum, one of which had no obvious deviation of the nasal dorsum and was not given special treatment, and one case underwent the cartilage graft of the nasal dorsum removed and replaced with silicone prosthesis. The incisions of the other patients healed by first intention, and there was no complication such as postoperative infection and prosthesis displacement. The nasal alar height symmetry index, nasal alar width symmetry index, nasal dorsum central axis deviation angle, and nasal columella deviation angle significantly improved after operation when compared with preoperative ones ( P<0.05). Postoperative subjective satisfaction evaluation reached the level of basic satisfaction or above, and most of them were very satisfied. Conclusion Comprehensive rhinoplasty using autologous rib cartilage grafting to construct a stable nasal tip support, combined with dorsal nasal prosthesis or autologous cartilage implantation, can achieve good effectiveness on secondary nasal deformity with saddle nasal deformity after cleft lip surgery.
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Affiliation(s)
- 明 陈
- 东南大学附属中大医院烧伤整形科(江苏南京 210008)Department of Burn and Plastic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210008, P. R. China
| | - 宗科 郭
- 东南大学附属中大医院烧伤整形科(江苏南京 210008)Department of Burn and Plastic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210008, P. R. China
| | - 冰 于
- 东南大学附属中大医院烧伤整形科(江苏南京 210008)Department of Burn and Plastic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210008, P. R. China
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23
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Tekin YE, Iyigun E, Karakoc O. The Effects of Two Different Cold Application Times on Edema, Ecchymosis, and Pain After Rhinoplasty: A Randomized Clinical Trial. J Perianesth Nurs 2024:S1089-9472(23)00988-7. [PMID: 38180392 DOI: 10.1016/j.jopan.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/04/2023] [Accepted: 10/01/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE This study was performed to determine the effects of different cold application times to the periorbital area after rhinoplasty on edema, ecchymosis, and pain. DESIGN A randomized clinical study. METHODS Patients were divided into two groups, and cold application was applied to one group for 4 hours and to the other for 48 hours. The cold application was applied with ice packs for 20 minutes every hour to the periorbital region in both groups. Data were collected with the Patient Information Form, Scoring Diagram for Edema, the Scoring Diagram for Ecchymosis, and the Visual Analogue Scale for Pain. FINDINGS Periorbital edema, eyelid ecchymosis, and pain were not significantly different between the two groups. The mean edema score of the 48-hour group was 0.87 ± 0.93, while the mean edema score of the 4-hour group was 0.70 ± 0.87 (P = .48) on the 2nd day. The mean ecchymosis score was found as 2.03 ± 1.12 in the 48-hour group and 2.10 ± 1.09 in the 4-hour group (P = .817). The mean pain score was 12.50 ± 17.40 in the 48-hour group and 13.00 ± 16.00 in the 4-hour group (P = .98). CONCLUSIONS The effects of 48-hour and 4-hour cold applications are similar. Cold application for 4 hours may be recommended to patients who undergo rhinoplasty, as it is more practical and easier to apply than the 48-hour practice.
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Affiliation(s)
- Yasemin Eda Tekin
- Nursing Department, Faculty of Health Sciences, Mudanya University, Bursa, Turkey.
| | - Emine Iyigun
- Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Turkey
| | - Omer Karakoc
- Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
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Yong M, Hollemon D, Baxter J, Hirst A, Bryning S, Fox A, Smith G, Hughes R, Brandolini G, Wolf S, Ow R. Economic impact analysis of a minimally invasive temperature-controlled radiofrequency device versus nasal surgery for the treatment of nasal airway obstruction in the United States. J Med Econ 2024; 27:708-714. [PMID: 38581156 DOI: 10.1080/13696998.2024.2340385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/04/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE To determine the economic impact of a minimally invasive temperature-controlled radiofrequency (TCRF) device for treating nasal airway obstruction (NAO). METHODS A budget impact model was developed for two scenarios: a reference scenario of functional rhinoplasty surgery with concomitant septoplasty and inferior turbinate reduction (ITR) performed in the hospital outpatient department where TCRF is not an available treatment option and a new scenario consisting of in-office TCRF treatment of the nasal valve and ITR. A payor perspective was adopted with a hypothetical population plan size of one million members. Costs were estimated over a time horizon of 4 years. The eligible population included patients with severe/extreme NAO and nasal valve collapse (NVC) as the primary cause or significant contributor. Data inputs were sourced from targeted literature reviews. Uncertainty within the model structure and input parameters was assessed using one-way sensitivity analysis. RESULTS The introduction of a TCRF device resulted in population-level cost savings of $20,015,123 and per-responder average cost savings of $3531 through a 4-year time horizon due to lower procedure costs and complication rates of the device relative to the surgical comparator. Results were robust when varying parameter values in sensitivity analyses, with cost savings being most sensitive to the prevalence of NAO and estimated response rates to functional rhinoplasty and TCRF. CONCLUSIONS In patients with severe/extreme NAO, with NVC as the primary or major contributor, introducing TCRF with ITR as a treatment option demonstrates the potential for significant cost savings over functional rhinoplasty with septoplasty and ITR.
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Affiliation(s)
| | | | | | | | | | - Aimee Fox
- Adelphi Values PROVE, Bollington, UK
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25
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Yang C, Goslawski A, Li S, Rabbani CC. Osteocutaneous Radial Forearm Free Tissue Transfer for Reconstruction of Total Septectomy and Partial Rhinectomy Defect. Otolaryngol Head Neck Surg 2024; 170:301-304. [PMID: 37702157 DOI: 10.1002/ohn.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/07/2023] [Accepted: 08/12/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Chim Yang
- Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
| | - Amanda Goslawski
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Shawn Li
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Cyrus C Rabbani
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Jeong JY, Kim TK, Ku I, Najmiddinov B. Nasal Osteotomies Revisited in Asians: Surface Aesthetics, Anatomical and Technical Considerations. Arch Plast Surg 2024; 51:2-13. [PMID: 38425847 PMCID: PMC10901595 DOI: 10.1055/a-2201-8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/25/2023] [Indexed: 03/02/2024] Open
Abstract
Background Although osteotomy is commonly performed in rhinoplasty, it is difficult for less experienced surgeon to understand mechanism of the procedure. The primary goal of this study is to improve understanding of nasal osteotomy in Asians by considering the surface aesthetics and anatomy of the nose as well as their relationships with the surgical procedure. Methods Surface aesthetics, anatomic considerations, kinetics of medial and lateral osteotomy, fracture levels of osteotomy were discussed in detail by reviewing the previous publications and 18 years of our experience. Moreover, the technical details of osteotomy were explained and personal tips for performing successful osteotomy were described. Results Dorsal and lateral aesthetic lines, dorsal and basal widths are main characteristics related to the surface aesthetics of nose to perform the osteotomy. In addition, these features are different in Asian population due to the anatomic difference with Caucasians, which makes the procedure difficult and requires more attention to perform osteotomy. Conclusion Because osteotomy is one of the most traumatic and invasive part of the rhinoplasty, it is crucial for the rhinoplasty surgeon to understand the relationship between surface aesthetics and osteotomy techniques to produce consistent and reproducible results.
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Affiliation(s)
- Jae-Yong Jeong
- THE PLUS Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Taek-Kyun Kim
- THE PLUS Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Inhoe Ku
- THE PLUS Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Bakhtiyor Najmiddinov
- Plastic and Reconstructive Surgery, Shox International Hospital, Tashkent, Uzbekistan
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27
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Park JJ, Rodriguez Colon R, Arias FD, Laspro M, Chaya BF, Rochlin DH, Staffenberg DA, Flores RL. "Septoplasty" Performed at Primary Cleft Rhinoplasty: A Systematic Review of Techniques and Call for Accurate Terminology. Cleft Palate Craniofac J 2023; 60:1645-1654. [PMID: 35837698 DOI: 10.1177/10556656221113997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Primary cleft nasal repair can include septal reconstruction. We hypothesize that primary cleft septoplasty and adult septoplasty have fundamental differences that render these procedures as distinct surgical entities. DESIGN Systematic review of the PubMed, Cochrane, and Embase databases performed on pediatric cleft and general adult septoplasty techniques through December 2021. (PROSPERO ID CRD42022295763). MAIN OUTCOME MEASURES Collected data included information on septal dissection, septal detachment, and management of the bony and cartilaginous septum. RESULTS Twenty-eight pediatric cleft septoplasty and 229 adult septoplasty studies were included. Dissection in primary cleft septoplasty was limited to the anterocaudal septum, while secondary cleft septoplasty and adult septoplasty techniques entailed wide exposures of the cartilaginous septum with or without exposure of the perpendicular plate of the ethmoid. In primary cleft septoplasty, detachment of the septum was mostly limited to the nasal spine and anterior base of the cartilaginous septum, while secondary cleft septoplasty and adult septoplasty included detachment from the vomer, and ethmoid. In the few reports of cartilage excision during primary cleft septoplasty, removal was limited to the anterior inferior border of the septum, while secondary cleft septoplasty and adult septoplasty included excision of the cartilaginous and bony septum. CONCLUSION Primary cleft septoplasty is distinct from septoplasty performed on facially mature patients. More specifically, septal dissection and detachment are limited to the anterior caudal area during primary lip repair, with rare removal of cartilage or bone. Given these differences, the authors suggest the term "septal reset" to describe septoplasty performed during primary cleft nasal repair.
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Alsanea M, Alshaalan YJ, Alkraidees M, Alramyan R, Waheed SK. Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire (FACE-Q) Arabic Validation. Cureus 2023; 15:e51135. [PMID: 38283495 PMCID: PMC10811412 DOI: 10.7759/cureus.51135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2023] [Indexed: 01/30/2024] Open
Abstract
Background Rhinoplasty, a common cosmetic surgery, improves aesthetic appearance and nasal function. Outcomes are typically measured by patient satisfaction and quality of life impact. However, a gap exists in validated non-English assessment tools, especially in Arabic, which hinders accurately capturing patient experiences in Arabic-speaking populations. To fill this gap, this study aims to translate and validate the "Rhinoplasty" module of the Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire (FACE-Q) self-questionnaire into Arabic. Methods A cross-sectional study was conducted at the Otorhinolaryngology Department of the National Guard Health Affairs in Riyadh, Saudi Arabia. Adults who underwent rhinoplasty from 2017 to 2021 were included if they had at least one year of follow-up and were contactable. A sample size of 109 was determined, and the participants were selected using probability cluster sampling. A 33-item FACE-Q scale was administered via telephone, with scores converted to a 0-100 scale for analysis. Translation involved a two-way process with independent translations and back-translations, followed by review and pilot testing. Results The study included 137 participants (mean age, 32.5 years; 53 men, 84 women), predominantly electing cosmetic surgery, with an average of four years post-surgery. The internal consistency of the scales varied, with the self-acceptance/love scale showing acceptable reliability (Cronbach's alpha = 0.73) and other scales suggesting item redundancy (Cronbach's alpha for aesthetic scales > 0.94). The self-rated complications scale did not meet the acceptability threshold, indicating a need for scale revision. Conclusions The Arabic translation of the FACE-Q Rhinoplasty module shows potential as a reliable tool for evaluating patient satisfaction and quality of life after rhinoplasty in Arabic-speaking patients. Further refinement is necessary to address item redundancy and enhance cultural specificity. This work underscores the importance of culturally sensitive tools for global applicability in cosmetic surgery outcomes research.
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Affiliation(s)
- Mohammd Alsanea
- Otolaryngology - Head and Neck Surgery, King Abdulaziz Medical City, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, King Abdullah International Medical Research Center, Riyadh, SAU
- Otolaryngology, Ministry of National Guard Health Affairs, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Yazeed J Alshaalan
- General Practice, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- General Practice, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Mohammad Alkraidees
- Otolaryngology, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Otolaryngology, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Rana Alramyan
- Otolaryngology, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Shaikh K Waheed
- Otolaryngology - Head and Neck Surgery, King Abdulaziz Medical City, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, King Abdullah International Medical Research Center, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, Ministry of National Guard Health Affairs, Riyadh, SAU
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Ahmed MB, Al-Mohannadi FS, Elzawawi KE, Alsherawi A, Althalathini M. Excision and reconstruction of dorsal nasal mucous cyst using dorsal nasal flap technique: a case report and literature review. J Surg Case Rep 2023; 2023:rjad667. [PMID: 38111496 PMCID: PMC10725821 DOI: 10.1093/jscr/rjad667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
Congenital nasal masses are very rare presentations. Among these masses is a mucous cyst, which might be considered either a congenital or an acquired mass. Our report presents a case of recurrent dorsal nasal swelling that was initially managed with an open rhinoplasty. However, 1 year after the surgery, the swelling started to grow rapidly, and the patient presented with a disfigured nose. We scheduled the patient for the excision of the dorsal nasal swelling and reconstruction using the dorsal nasal flap approach. Several surgical techniques have been performed and published in the literature; however, this is the first time the dorsal nasal flap technique is being reported as a surgical approach to dorsal nasal mucous cysts. While mucous cyst formation might be congenital, the majority occur after rhinoplasty surgery. However, they can be prevented by minimizing unnecessary trauma during the surgery and ensuring the thorough removal of all epithelial tissue and foreign bodies.
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Affiliation(s)
- Mohamed B Ahmed
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Fatima S Al-Mohannadi
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Abeer Alsherawi
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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30
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Taylor CM, Marino MJ, Bansberg SF. Septal Perforation Repair Quality of Life Outcomes Using the Revised 15-item Glasgow Benefit Inventory. Ann Otol Rhinol Laryngol 2023; 132:1550-1556. [PMID: 37157824 DOI: 10.1177/00034894231170938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND The 18-item Glasgow Benefit Inventory (GBI) has been widely used to measure patient general health response to otorhinolaryngologic and facial plastic interventions. The GBI was recently reorganized into 15 questions with 5 sub-scale factors (GBI-5F) to improve its utility. Application of the GBI-5F to septal perforation treatments may improve our understanding of quality of life outcomes. METHODOLOGY/PRINCIPAL The GBI was given to patients seen from August 2018 through October 2021 who were at least 6 months postoperative attempted perforation surgical closure using bilateral nasal mucosal flaps with an interposition graft. Original GBI and GBI-5F scores were computed and subgroup analysis performed in this retrospective medical record review. RESULTS Of the 98 patients (mean age 45.5 years) who met study criteria, 65 were female. Mean perforation length was 12.9, and height 9.7 mm. The mean postoperative time to GBI completion was 12.7 months. Highest GBI-5F scores were noted in the Quality of Life factor, followed by Self-confidence and Social Involvement. Females reported significantly higher scores than men. Total GBI scores were similar to those recorded for other rhinologic procedures. CONCLUSIONS The GBI-5F provides measurable insight into patient quality of life benefit following septal perforation repair.
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Affiliation(s)
- Cullen M Taylor
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Michael J Marino
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Stephen F Bansberg
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
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Bracaglia R, Servillo M, Fortunato R, Caretto AA, Gentileschi S. Double Lateral Osteotomy: Not Only the Correction of Crooked Noses but a Relevant Aesthetical Refinement in Structural Rhinoplasty. J Pers Med 2023; 13:1619. [PMID: 38003934 PMCID: PMC10672257 DOI: 10.3390/jpm13111619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Osteotomy represents a crucial step in structural rhinoplasty; however, there is not a unique approach accepted. Double lateral osteotomy has proven to be effective in the long-term correction of a deviated nose. In this series, we evaluated its aesthetic value also in non-deviated cases. MATERIALS AND METHODS 864 patients who underwent primary structural rhinoplasty from 2012 to 2020 were divided into four groups. Group A and B included patients with a crooked nose treated with asymmetrical double osteotomy and bilateral double osteotomy, respectively. Patients who did not present nasal deviation were divided into group C, including cases treated with bilateral single osteotomy, and group D, including patients who underwent bilateral double osteotomy. Postoperative evaluations were performed by three independent plastic surgeons blinded to the surgical technique. Patient's satisfaction was assessed through the FACE-Q rhinoplasty module. RESULTS FACE-Q scores reported a satisfaction rate higher than 30% for every item in all groups; however, group B and group D showed statistically higher satisfaction (p < 0.01). According to the evaluations performed by physicians, group B and group D showed the most satisfactory outcomes (p < 0.01). CONCLUSIONS bilateral double osteotomies represent a significant aesthetic refinement in structural rhinoplasty, not only in crooked noses but also in non-deviated cases, since the reduction in the width of the nose is an aesthetical aspect very appreciated by patients.
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Affiliation(s)
- Roberto Bracaglia
- Department of Plastic Surgery, Bracaglia Aesthetic Center, Villa Stuart Clinic, Eurosanità s.p.a., Via Trionfale 5952, 00135 Rome, Italy
| | - Maria Servillo
- Department of Plastic Surgery, Bracaglia Aesthetic Center, Villa Stuart Clinic, Eurosanità s.p.a., Via Trionfale 5952, 00135 Rome, Italy
| | - Regina Fortunato
- Department of Plastic Surgery, Bracaglia Aesthetic Center, Villa Stuart Clinic, Eurosanità s.p.a., Via Trionfale 5952, 00135 Rome, Italy
| | - Anna Amelia Caretto
- Department of Plastic Surgery, Department of Women’s, Children’s and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, L. go Agostino Gemelli 1, 00168 Rome, Italy (S.G.)
| | - Stefano Gentileschi
- Department of Plastic Surgery, Department of Women’s, Children’s and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, L. go Agostino Gemelli 1, 00168 Rome, Italy (S.G.)
- Dipartimento di Medicina e Chirurgia Traslazionale, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Erisgin Z, Hizli O, Yildirim G, Sivrikaya C, Sarisoy AB, Avci Y, Ozcan KM. Use of hyaluronic acid matrix in dorsal augmentation rhinoplasty. Biotech Histochem 2023; 98:561-566. [PMID: 37646474 DOI: 10.1080/10520295.2023.2248889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Augmentation rhinoplasty sometimes is required for patients with saddle nose deformity caused by failed rhinoplasty or facial trauma; finding appropriate grafting material remains a significant problem for this procedure. We investigated hyaluronic acid matrix as an allograft for dorsal augmentation rhinoplasty in a rabbit model. We performed an osteotomy on the nasal bones of eight rabbits. Four animals were sham operated as the control group and four were administered a mixture of saline-gelled hyaluronic acid matrix and sliced cartilage. Ultrasonography and three-dimensional reconstruction tomography were performed at the end of the experimental period. After sacrifice of the animals, nasal tissues were examined for histopathology, and both collagen scores and number of capillaries were compared between the two groups. Increased collagen and capillaries were apparent in the hyaluronic acid matrix group compared to controls. The median collagen score was significantly greater for the hyaluronic acid matrix group than for the control group. Although the number of capillaries for the hyaluronic acid matrix group was greater than for the control group, the difference was not statistically significant. Three weeks is sufficient for adhesion of ends of fractures in clinical practice; however, we found no ossification at this time in either group. A hyaluronic acid matrix may be a useful alternative supplement for dorsal augmentation rhinoplasty. Development of collagen was commensurate with membranous ossification; however, assessment of complete ossification requires a longer experimental period.
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Affiliation(s)
- Zuleyha Erisgin
- Department of Histology and Embryology, Faculty of Medicine, Giresun University, Giresun, Türkiye
| | - Omer Hizli
- Department of Otolaryngology, Faculty of Medicine, Balikesir University, Balikesir, Türkiye
| | - Guven Yildirim
- Department of Otolaryngology, Faculty of Medicine, Giresun University, Giresun, Türkiye
| | - Cengiz Sivrikaya
- Department of Otolaryngology, Giresun Ilhan Ozdemir Research Hospital, Giresun, Türkiye
| | - Ahmet Burcin Sarisoy
- Department of Otolaryngology, Mehmet Akif Ersoy State Hospital, Canakkale, Türkiye
| | - Yonca Avci
- Department of Otolaryngology, Faculty of Medicine, Giresun University, Giresun, Türkiye
| | - Kursat Murat Ozcan
- Department of Otolaryngology, Faculty of Medicine, Giresun University, Giresun, Türkiye
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Eitan DN, Grunebaum LD, Howard BE. Actinomyces: An Under Appreciated Cause of Postoperative Infection in Rhinoplasty. Laryngoscope 2023; 133:2948-2950. [PMID: 36912365 DOI: 10.1002/lary.30639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To discuss a case series of Actinomyces infection post-rhinoplasty and review the literature for correct diagnosis and management. STUDY DESIGN Case series with chart review. METHODS Three cases are presented of patients with a history of recurrent infectious symptoms post revision rhinoplasty later being diagnosed as Actinomyces. RESULTS Three patients were identified having undergone revision rhinoplasty and later being diagnosed with Actinomyces infection. They initially presented with underwhelming physical exams, mild erythema, slight swelling, yet extreme pain. They also had periods of recurrent infection once antibiotics were stopped. Aerobic, anaerobic, fungal, and Actinomyces cultures were sent to pathology and returned positive for Actinomyces. Treatment typically involved a combination of prolonged antibiotics, incision and drainage, and/or surgical debridement. CONCLUSIONS Awareness of Actinomyces as a possible cause of infection post-rhinoplasty is significant as this pathogen can lead to extensive tissue destruction and fistula formation which could be detrimental for a rhinoplasty. Duration of treatment is beyond typical lengths for other infections and a specific culture for Actinomyces is required to be sent as it isn't captured in standard aerobic/anaerobic cultures. Therefore, a high index of suspicion is required by physicians to ensure that patients are evaluated thoroughly. Laryngoscope, 133:2948-2950, 2023.
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Affiliation(s)
- Dana N Eitan
- Creighton University School of Medicine, Phoenix, Arizona, USA
| | - Lisa D Grunebaum
- Division of Facial Plastic Surgery, Department of Otolaryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Brittany E Howard
- Division of Facial Plastic Surgery, Department of Otolaryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA
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Bhowmik RT, Kandathil CK, Most SP. Automating the Standardized Cosmesis and Health Nasal Outcomes Survey Classification with Convolutional Neural Networks. Facial Plast Surg Aesthet Med 2023; 25:487-493. [PMID: 36749153 DOI: 10.1089/fpsam.2022.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Importance: Currently, the aesthetic appearance and structure of the nose in a rhinoplasty patient is evaluated by a surgeon, without automation. Objective: To compare the assessment of convolutional neural networks (CNNs) (machine learning) and a rhinoplasty surgeon's impression of the nose before rhinoplasty. Methods: Preoperative nasal images were scored using a modified standardized cosmesis and health nasal outcomes survey (SCHNOS) questionnaire. Artificial intelligence (AI) models based on CNNs were developed and trained to classify patient nasal aesthetics into one of five categories, representing even intervals on the SCHNOS scoring scale. The models' performances were benchmarked against expert surgeon evaluation. Results: Two hundred thirty-five preoperative patient images were included in the study. The best-performing AI model achieved 61% accuracy and 0.449 average Matthews Correlation Coefficient on new patients. Conclusions: This pilot study suggests a proof-of-concept for AI to allow an automated patient assessment tool trained on preoperative patient images with a potential utility for counseling rhinoplasty patients.
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Affiliation(s)
- Rohan T Bhowmik
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA
- The Harker School, San Jose, California, USA
| | - Cherian K Kandathil
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA
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Baharmand I, Sheikh-Oleslami S, Pascual Rodríguez A, Hernaiz-Leonardo JC, Alim BM, Javer AR. The Effects of Nasal Surgery on Pulmonary Function: A Systematic Review and Meta-Analysis. Laryngoscope 2023; 133:2837-2845. [PMID: 36896873 DOI: 10.1002/lary.30651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/10/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE A deviated nasal septum (DNS) can result in an anatomical obstruction and impact lung function through prolonged suboptimal inspiration. Given the improvements in respiration reported by patients following septoplasty or septorhinoplasty (with or without inferior turbinate reduction), our study investigated the effect of these procedures on pulmonary function through a systematic review and meta-analysis. DATA SOURCES Medline, Embase, Cochrane Databases, Web of Science, and Google Scholar. REVIEW METHODS The review was registered with PROSPERO [CRD42022316309]. The study population was composed of adult patients (18-65) who were symptomatic with confirmed DNS. Extracted outcomes (pre-operative versus postoperative) included the six-minute walk test (6MWT) and pulmonary function tests (FEV1, FVC, FEV1/FVC, FEF25-75, PEF). Meta-analyses were performed using a random-effects model. RESULTS Three studies included measures of the 6MWT in meters and all three found a statistically significant increase in the distance walked after surgery with a mean difference of 62.40 m (95% CI 24.79-100.00). Statistically significant improvements in PFT outcomes were observed with a standard mean difference of 0.72 for FEV1 (95% CI 0.31-1.13), 0.63 for FVC (95% CI 0.26-1.00), and 0.64 for PEF (95% CI 0.47-0.82). Of the twelve studies which measured PFT outcomes, six showed statistically significant improvements, three studies showed mixed results, and three studies found no difference in PFT outcomes between pre-and post-surgery testing. CONCLUSIONS The present study suggests that pulmonary function does improve after nasal surgery for DNS, but the high heterogeneity observed in the meta-analyses indicates that the evidence supporting this conclusion is low. Laryngoscope, 133:2837-2845, 2023.
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Affiliation(s)
- Iman Baharmand
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sara Sheikh-Oleslami
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Athenea Pascual Rodríguez
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Juan Carlos Hernaiz-Leonardo
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bader M Alim
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amin R Javer
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada
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36
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Greenlund LK, Tan SR, Dresner HS. Nasal Sesamoid Cartilages: Fact or Fiction? An Anatomical Study of the Lateral Nasal Ala. Ann Otol Rhinol Laryngol 2023; 132:1438-1442. [PMID: 37002594 DOI: 10.1177/00034894231165134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVES To evaluate the presence of cartilage in the lateral nasal ala (LNA) via histological analysis of alar Mohs surgical specimens. An accurate understanding of nasal anatomy is essential to optimize esthetic and reconstructive surgical outcomes. LNA anatomy is typically pictured to include discreet accessory and sesamoid cartilages; however, the authors debate the actual presence of these structures. METHODS A blinded reviewer analyzed 101 lateral nasal alar histologic specimens from 362 tissue blocks using a Hematoxylin and Eosin (H&E) stain to assess for the presence of cartilage. RESULTS Out of the 362 tissue blocks histologically analyzed, only 1 included cartilaginous components. CONCLUSIONS We conclude that the presence of sesamoid and accessory cartilages in the LNA within our sample set is exceedingly rare.
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Affiliation(s)
| | - Stephen R Tan
- Health Partners Department of Dermatology, St. Paul, MN, USA
| | - Harley S Dresner
- University of Minnesota Medical School, Minneapolis, MN, USA
- Health Partners Department of Otolaryngology, St. Paul, MN, USA
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Lim B, Seth I, Kah S, Sofiadellis F, Ross RJ, Rozen WM, Cuomo R. Using Generative Artificial Intelligence Tools in Cosmetic Surgery: A Study on Rhinoplasty, Facelifts, and Blepharoplasty Procedures. J Clin Med 2023; 12:6524. [PMID: 37892665 PMCID: PMC10607912 DOI: 10.3390/jcm12206524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Artificial intelligence (AI), notably Generative Adversarial Networks, has the potential to transform medical and patient education. Leveraging GANs in medical fields, especially cosmetic surgery, provides a plethora of benefits, including upholding patient confidentiality, ensuring broad exposure to diverse patient scenarios, and democratizing medical education. This study investigated the capacity of AI models, DALL-E 2, Midjourney, and Blue Willow, to generate realistic images pertinent to cosmetic surgery. We combined the generative powers of ChatGPT-4 and Google's BARD with these GANs to produce images of various noses, faces, and eyelids. Four board-certified plastic surgeons evaluated the generated images, eliminating the need for real patient photographs. Notably, generated images predominantly showcased female faces with lighter skin tones, lacking representation of males, older women, and those with a body mass index above 20. The integration of AI in cosmetic surgery offers enhanced patient education and training but demands careful and ethical incorporation to ensure comprehensive representation and uphold medical standards.
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Affiliation(s)
- Bryan Lim
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Ishith Seth
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Skyler Kah
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
| | - Foti Sofiadellis
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
| | - Richard J. Ross
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
| | - Warren M. Rozen
- Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Roberto Cuomo
- Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
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Zakariaei Z, Fakhar M, Bari S, Derakhshani M, Banimostafavi ES, Soleymani M. Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty. Clin Med Insights Case Rep 2023; 16:11795476231186913. [PMID: 37799763 PMCID: PMC10548795 DOI: 10.1177/11795476231186913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 10/07/2023]
Abstract
Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis.
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Affiliation(s)
- Zakaria Zakariaei
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Simin Bari
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Derakhshani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Sadat Banimostafavi
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mostafa Soleymani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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Rand D, Dlouhy BJ, Kanotra SP. Extended External Rhinoplasty Approach For Nasal Dermoids With Intracranial Extension. Laryngoscope 2023; 133:2798-2802. [PMID: 36688249 DOI: 10.1002/lary.30551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 01/24/2023]
Abstract
We present an extended external rhinoplasty approach with bilateral marginal and alar base incisions for removal of a nasal dermoid cyst with intracranial extension in a 3-year-old patient. This approach provides adequate exposure, enables nasal bone osteotomies, and allows access to the skull base while achieving a cosmetically acceptable scar. Laryngoscope, 133:2798-2802, 2023.
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Affiliation(s)
- Dayton Rand
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Brian J Dlouhy
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Sohit Paul Kanotra
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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40
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Yu B, Zhou G, Fu Q, Yang Y, Li S, Zheng C, Chen M. Post- rhinoplasty complications with previous hyaluronic acid injection history: Cerebral infarction and vision loss. J Cosmet Dermatol 2023; 22:2677-2681. [PMID: 37042561 DOI: 10.1111/jocd.15775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/31/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Rhinoplasty is becoming increasingly frequent as the pursuit of aesthetics by people accelerates. In recent years, the proportion of people opting for rhinoplasty injections has gradually increased. This has led to numerous reports citing catastrophic postoperative complications such as skin necrosis, cerebral infarction, and visual impairment. AIM The aim of our report is to discuss the possible etiological factors for this post-rhinoplasty complication and provides a rationale for HA injection history as a risk factor in rhinoplasty. METHODS We report a rare case that received nasal HA injections in the past without any untoward incident. She opted for a second rhinoplasty 2 years after her initial nasal HA injections. This second intervention led to post-injection loss of vision in one eye and cerebral infarction. Following clinical and radiological examination, digital subtraction angiography (DSA) and superselective intra-arterial thrombolysis were performed. RESULTS The patient did not develop disuse exotropia or ocular atrophy, but the left eye remained without light perception, which implies that intra-arterial thrombolytic therapy may be a positive and effective method to maintain the normal appearance of the eye. CONCLUSION It is advisable for patient safety to maintain a long interval of time between hyaluronidase injection and repeat rhinoplasty. Clinicians should become familiar with the anatomical peculiarities of the patient and be gentle during the rhinoplasty procedure.
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Affiliation(s)
- Boya Yu
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yi Yang
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shiyi Li
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Can Zheng
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
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Mims MM, Shockley WW, Clark JM. Casual Observers' Perception on the Aesthetics of the Butterfly Graft. Laryngoscope 2023; 133:2578-2583. [PMID: 36602076 DOI: 10.1002/lary.30562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/22/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The butterfly graft is an effective technique for improving the internal nasal valve, however, there is hesitancy among surgeons due to possible aesthetic changes. This study aims to determine if average observers rated the post-operative appearance of the butterfly graft negatively. METHODS An online survey was distributed by social media to non-medical observers in which they rated either the pre-operative or post-operative appearance of 22 patients' noses (11 butterfly graft, 11 spreader graft). A heat map was used to determine if the supratip region was rated as the least aesthetically appealing. Post-operative ratings and heat maps of the butterfly graft patients were compared to pre-operative ratings as well as ratings of the spreader graft group. RESULTS 226 observers responded. There was no difference in the pre-operative and post-operative rating of the butterfly graft group (58.27 vs. 58.00, p = 0.88) or the number of supratip regions selected as least attractive (165 vs. 169, p = 0.60). Similarly, there was no difference in post-operative ratings between the butterfly graft group and spreader graft group (58.00 vs. 58.21, p = 0.63) or in selection of the supratip as the least attractive region (169 vs. 172, p = 0.74). CONCLUSION The butterfly graft did not negatively affect observers' opinion of patients' noses. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2578-2583, 2023.
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Affiliation(s)
- Mark M Mims
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - William W Shockley
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joseph Madison Clark
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina, Chapel Hill, North Carolina, USA
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Deot N, Kiprovski A, Hatala A, Obayemi A, Suryadevara A, Davila RO. Evaluation of Mobile and Digital Single-Lens Reflex Photography for Facial Surgical Analysis. Laryngoscope 2023; 133:2590-2596. [PMID: 36651350 DOI: 10.1002/lary.30573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/15/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVES High-quality perioperative photography is imperative to good surgical planning in facial reconstructive and aesthetic surgery. We explore the utility of an add-on smartphone telephoto lens to avoid the distortions noted in prior studies using smartphone cameras. METHODS Standard perioperative photographs of the same subject were taken with three distinct cameras using a dual-ring light setup. The three camera setups iPhone 11 alone, iPhone 11 with the 58 Moment telephoto lens attachment, and a D3300 Nikon DSLR APS-C sensor camera with a 60 mm NIKKOR F2.8G ED macro lens were compared using a 47-question online survey consisting of demographic and image-specific questions sent to plastic surgeons. RESULTS Forty-nine facial plastic surgeons completed the survey. The iPhone 11 alone was identified as having the lowest quality for central/peripheral distortion (83%), columella/caudal septum/alar anatomy (58.3%), and skin quality (38.3%). With the addition of the telephoto lens, the ability to assess all categories was significantly improved. 53.1% (n = 26) of respondents found the iPhone 11 + 58 mm telephoto lens setup to be the most useful for perioperative surgical planning. CONCLUSIONS Smartphone photography with the addition of a telephoto lens can offer a comparable option to the DSLR with regard to photo quality and detail. SUMMARY A telephoto add-on lens is an effective solution to overcome the central distortion seen in images taken by the iPhone for perioperative photography. This photo quality was found to be comparable to that of traditional DSLR cameras in our survey study. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2590-2596, 2023.
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Affiliation(s)
- Neal Deot
- Department of Otolaryngology, Upstate Medical University, Syracuse, New York, U.S.A
| | | | - Adam Hatala
- Upstate Medical University, Syracuse, New York, U.S.A
| | - Ade Obayemi
- Department of Otolaryngology, Upstate Medical University, Syracuse, New York, U.S.A
| | - Amar Suryadevara
- Department of Otolaryngology, Upstate Medical University, Syracuse, New York, U.S.A
| | - Richard O Davila
- Department of Otolaryngology, Upstate Medical University, Syracuse, New York, U.S.A
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Markushin AA, Nashvan AK, Shilin SS, Kuznetsov ND, Glukhova AI, Vasyakova SM, Grigoryak NM, Ganshin IB, Antonyan AA, Drozdova GA. Comparison of Acute Pain Syndrome after Surgical Interventions in the Nasal Cavity and Rhinoplasty. DOKL BIOCHEM BIOPHYS 2023; 512:256-260. [PMID: 38093126 DOI: 10.1134/s1607672923700424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 12/18/2023]
Abstract
Comparison of acute pain syndrome after septoplasty, rhinoplasty, and rhinoseptoplasty was carried out. It is shown that the intensity of acute pain is higher in patients after rhinoseptoplasty in the first 3-6 h after surgery.
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Affiliation(s)
- A A Markushin
- Russian Peoples' Friendship University, Moscow, Russia
| | - A K Nashvan
- Russian Peoples' Friendship University, Moscow, Russia
- University Clinical Hospital, Damascus, Syria
| | - S S Shilin
- Russian Peoples' Friendship University, Moscow, Russia.
| | - N D Kuznetsov
- Russian Peoples' Friendship University, Moscow, Russia
| | - A I Glukhova
- Russian Peoples' Friendship University, Moscow, Russia
| | - S M Vasyakova
- Russian Peoples' Friendship University, Moscow, Russia
| | - N M Grigoryak
- Russian Peoples' Friendship University, Moscow, Russia
| | - I B Ganshin
- Russian Peoples' Friendship University, Moscow, Russia
| | - A A Antonyan
- Russian Peoples' Friendship University, Moscow, Russia
| | - G A Drozdova
- Russian Peoples' Friendship University, Moscow, Russia
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Hosnani H, Bastaninez S, Golchin A, Givzadeh H. Evaluation of the Results of Septum Extension Batten Graft in Patients Referred for Septo rhinoplasty. Int Arch Otorhinolaryngol 2023; 27:e602-e607. [PMID: 37876689 PMCID: PMC10932729 DOI: 10.1055/s-0043-1768211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/19/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Correction of caudal septal deviations has always been a challenging subject in septorhinoplasty. The septum batten extension graft (SBEG) is a new graft that has potential properties in rhinoplasty. However, few reports have evaluated the surgical outcomes of this technique. Objective The purpose of this study was to evaluate the effectiveness of SBEG in correcting caudal septal deviation. Methods This cross-sectional study was conducted on patients with caudal septal deviation undergoing septorhinoplasty using SBEG at 2 different hospitals in 2019. We then retrospectively reviewed medical records and photographs of 50 patients at the preoperative period, as well as at 1-month, and 12-month postoperatively. Gross changes in nasolabial angle, columellar show, nasal tip projection, and dorsal nasal deviation were evaluated by a photographic analysis method, and nasal obstruction was assessed by patient satisfaction with breathing. Results There was a significant difference between the mean nasolabial angle and columellar show at 1 and 12-months postoperatively, compared with the previous values ( p < 0.0001). The nasolabial angles were in a favorable position with an increase of 12 to 15 degrees compared with the preoperative state. The columellar show also improved by an average of 1.2 mm and was in good condition. The postoperative dorsal nasal deviation was significantly reduced, and projection was significantly increased (3.521 ± 0.087 mm vs. 0.719 ± 0.028; p < 0.0001; p < 0.001). Moreover, this method had a significant favorable effect on nasal obstruction ( p = 0.049). Conclusion Our results showed that septorhinoplasty using SBEG is useful for correcting caudal septal deviation, with favorable surgical outcomes, and it has responded well to all five aforementioned criteria.
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Affiliation(s)
- Hamidreza Hosnani
- Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Bastaninez
- Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirbahador Golchin
- Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Givzadeh
- Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Lee SB, Min HJ. Spontaneous Fracture of a Silicone Implant: A Delayed Complication of Rhinoplasty. Ear Nose Throat J 2023:1455613231200829. [PMID: 37743756 DOI: 10.1177/01455613231200829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Silicone implants are commonly used alloplastic materials for rhinoplasty in Asia, as they are easy to manipulate, provide adequate volume augmentation, and exhibit excellent biocompatibility. However, they are associated with complications such as infection, displacement, and extrusion. Recently, we encountered an interesting complication in a 53-year-old woman presenting with palpable and visible stepping of the nasal dorsum. The patient had previously undergone rhinoplasty with an L-shaped silicone implant, and symptoms had been noticeable for approximately 1 year. Lateral nasal computed tomography revealed a fractured silicone implant. Because the patient reported no history of nasal trauma since rhinoplasty, we assumed that the silicone implant might have fractured spontaneously. The findings in this case suggest that spontaneous implant fracture can be a late complication of rhinoplasty with silicone implant.
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Affiliation(s)
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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Gao Y, Liu W(V, Li L, Liu C, Zha Y. Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage. Diagnostics (Basel) 2023; 13:3044. [PMID: 37835786 PMCID: PMC10572289 DOI: 10.3390/diagnostics13193044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. MATERIALS AND METHODS This retrospective study included 190 set images of 38 participants, including axial T1- and T2-weighted FSE images using DLR (T1WIDL and T2WIDL, belong to FSEDL) and without using DLR (T1WIO and T2WIO, belong to FSEO) and 3D FSPGR images. Subjective evaluation (overall image quality, noise, contrast, artifacts, and identification of anatomical structures) was independently conducted by two radiologists. Objective evaluation including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was conducted using manual region-of-interest (ROI)-based analysis. Coefficient of variation (CV) and Bland-Altman plots were used to demonstrate the intra-rater repeatability of measurements for cartilage thickness on five different images. RESULTS Both qualitative and quantitative results confirmed superior FSEDL to 3D FSPGR images (both p < 0.05), improving the diagnosis confidence of the observers. Lower lateral cartilage (LLC), upper lateral cartilage (ULC), and septal cartilage (SP) were relatively well delineated on the T2WIDL, while 3D FSPGR showed poorly on the septal cartilage. For the repeatability of cartilage thickness measurements, T2WIDL showed the highest intra-observer (%CV = 8.7% for SP, 9.5% for ULC, and 9.7% for LLC) agreements. In addition, the acquisition time for T1WIDL and T2WIDL was respectively reduced by 14.2% to 29% compared to 3D FSPGR (both p < 0.05). CONCLUSIONS Two-dimensional equivalent-thin-slice T1- and T2-weighted images using DLR showed better image quality and shorter scan time than 3D FSPGR and conventional construction images in nasal cartilages. The anatomical details were preserved without losing clinical performance on diagnosis and prognosis, especially for pre-rhinoplasty planning.
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Affiliation(s)
- Yufan Gao
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | | | - Liang Li
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Changsheng Liu
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Kim DH, Park JB, Kim SW, Stybayeva G, Hwang SH. Effect of Infraorbital and/or Infratrochlear Nerve Blocks on Postoperative Care in Patients with Septo rhinoplasty: A Meta-Analysis. Medicina (Kaunas) 2023; 59:1659. [PMID: 37763778 PMCID: PMC10535682 DOI: 10.3390/medicina59091659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Through a comprehensive meta-analysis of the pertinent literature, this study evaluated the utility and efficacy of perioperative infraorbital and/or infratrochlear nerve blocks in reducing postoperative pain and related morbidities in patients undergoing septorhinoplasty. Materials and Methods: We reviewed studies retrieved from the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to August 2023. The analysis included a selection of seven articles that compared a treatment group receiving perioperative infraorbital and/or infratrochlear nerve blocks with a control group that either received a placebo or no treatment. The evaluated outcomes covered parameters such as postoperative pain, the amount and frequency of analgesic medication administration, the incidence of postoperative nausea and vomiting, as well as the manifestation of emergence agitation. Results: The treatment group displayed a significant reduction in postoperative pain (mean difference = -1.7236 [-2.6825; -0.7646], I2 = 98.8%), as well as a significant decrease in both the amount (standardized mean difference = -2.4629 [-3.8042; -1.1216], I2 = 93.0%) and frequency (odds ratio = 0.3584 [0.1383; 0.9287], I2 = 59.7%) of analgesic medication use compared to the control. The incidence of emergence agitation (odds ratio = 0.2040 [0.0907; 0.4590], I2 = 0.0%) was notably lower in the treatment group. The incidence of postoperative nausea and vomiting (odds ratio = 0.5393 [0.1309; 2.2218], I2 = 60.4%) showed a trend towards reduction, although it was not statistically significant. While no adverse effects reaching statistical significance were reported in the analyzed studies, hematoma (proportional rate = 0.2133 [0.0905; 0.4250], I2 = 76.9%) and edema (proportional rate = 0.1935 [0.1048; 0.3296], I2 = 57.2%) after blocks appeared at rates of approximately 20%. Conclusions: Infraorbital and/or infratrochlear nerve blocks for septorhinoplasty effectively reduce postoperative pain and emergence agitation without notable adverse outcomes.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (D.H.K.); (S.W.K.)
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (D.H.K.); (S.W.K.)
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA;
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Sagalow ES, Estephan LE, Kumar AT, Hwang M, Krein H, Heffelfinger R. Recovery Benefit With Total Intravenous Anesthesia in Patients Receiving Rhinoplasty. Otolaryngol Head Neck Surg 2023; 169:489-495. [PMID: 36906818 DOI: 10.1002/ohn.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE The aim was to evaluate the difference in recovery when comparing total intravenous anesthesia (TIVA) to inhalational gas anesthesia in patients receiving rhinoplasty. STUDY DESIGN Retrospective review. SETTING Postoperative anesthesia care unit (PACU). METHODS Patients who received a functional or cosmetic rhinoplasty at a single academic institution between April 2017 and November 2020 were included. Inhalational gas anesthesia was in the form of sevoflurane. Phase I recovery time, which was defined as the time it took a patient to reach ≥9/10 on the Aldrete scoring system was recorded, as well as the usage of pain medication in the PACU. The postoperative course and incidence of postoperative nausea and vomiting (PONV) were also collected. RESULTS Two hundred and two patients were identified with 149 (73.76%) who received TIVA and 53 (26.24%) who received sevoflurane. For the patients who received TIVA, the average recovery time was 101.44 minutes (standard deviation [SD]: 34.64) compared to an average recovery time of 121.09 minutes (SD: 50.19) for patients who received sevoflurane leading to a difference of 19.65 minutes (p = 0.002). Patients who received TIVA experienced less PONV (p = 0.001). There were no differences in the postoperative course including surgical or anesthesia complications, postoperative complications, hospital or Emergency Department admissions, or administration of pain medication (p > 0.05 for all). CONCLUSION When utilizing TIVA over inhalational anesthesia, patients undergoing rhinoplasty had significantly increased benefits in terms of reduced phase I recovery times and decreased incidence of PONV. TIVA was demonstrated to be a safe and efficacious method of anesthesia for this patient population.
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Affiliation(s)
- Emily S Sagalow
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Leonard E Estephan
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ayan T Kumar
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michelle Hwang
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Howard Krein
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ryan Heffelfinger
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Kulekci C. The Use of Piezoelectric Osteotomy Instruments During a Rhinoplasty Operation in a Patient With a Cochlear Implant. Cureus 2023; 15:e44833. [PMID: 37809178 PMCID: PMC10559662 DOI: 10.7759/cureus.44833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
A cochlear implant is a life-changing operation that significantly improves the lives of patients. Those with cochlear implants require ongoing measures to ensure the longevity of both their devices and their well-being. One concerning issue is the potential device failure due to the use of surgical instruments during procedures. In this report, we present a successful case of utilizing an ultrasonic osteotome for a primary septorhinoplasty in a 22-year-old patient who had undergone cochlear implant surgery 17 years prior. To our knowledge, this is the first recorded instance of applying a piezoelectric tool on a patient with a cochlear implant. Our findings support the safety of using a piezo osteotome in cochlear implant recipients.
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Affiliation(s)
- Cagri Kulekci
- Otolaryngology, Hacettepe University Faculty of Medicine, Ankara, TUR
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Lee DJ, Grose E, Brenna CTA, Philteos J, Lightfoot D, Kirubalingam K, Chan Y, Palmer JN, Adappa ND, Lee JM. The benefits and risks of non-steroidal anti-inflammatory drugs for postoperative analgesia in sinonasal surgery: a systematic review and meta-analysis. Int Forum Allergy Rhinol 2023; 13:1738-1757. [PMID: 36762711 DOI: 10.1002/alr.23140] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/26/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) have emerged as an alternative to opioids for optimal postoperative pain management. However, the adoption of NSAIDs in sinonasal surgery has been impeded by a theoretical concern for postoperative bleeding. Our objective is to systematically review the efficacy and safety of NSAIDs for patients undergoing sinonasal surgery. METHODS MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, and the WHO International Clinical Trials Registry Platform were searched from inception to January 27, 2022. Randomized controlled trials (RCTs) and comparative observational studies in any language were considered. Screening, data extraction, and risk of bias assessment were performed in duplicate. Our outcomes were postoperative pain scores, requirement for rescue analgesia, and postoperative adverse events (epistaxis, nausea/vomiting). RESULTS Out of 4661 records, 15 RCTs (enrolling 1210 patients) and two observational studies were included. Following endoscopic sinus surgery, there was no difference in pain scores between NSAIDs and non-NSAIDs groups (standardized mean differences [SMD] 0.44 units better, 95% CI -0.18 to 1.05). Following septorhinoplasty, NSAIDs decreased pain scores compared to non-NSAID regimens (SMD 1.14 units better, 95% CI 0.61 to 1.67 units better). Overall, NSAIDs reduced the need for rescue medication with a relative risk (RR) of 0.45 (95% CI 0.24 to 0.84). In addition, NSAIDs decreased the risk of nausea with an RR of 0.62 (95% CI 0.42 to 0.91) and did not increase the risk of epistaxis (RR 0.72, 95% CI 0.23-2.22). CONCLUSION Among patients undergoing sinonasal surgery, NSAIDs are beneficial in postoperative pain management and avoidance of postoperative nausea without increasing the risk of postoperative epistaxis.
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Affiliation(s)
- Daniel J Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elysia Grose
- Division of Rhinology, Department of Otolaryngology - Head & Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Connor T A Brenna
- Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Justine Philteos
- Division of Rhinology, Department of Otolaryngology - Head & Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - David Lightfoot
- St. Michael's Hospital Health Sciences Library, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Yvonne Chan
- Division of Rhinology, Department of Otolaryngology - Head & Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
| | - James N Palmer
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nithin D Adappa
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John M Lee
- Division of Rhinology, Department of Otolaryngology - Head & Neck Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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