Concurrent endoscopic sinus surgery and rhinoplasty

Concerns over increased surgical risk and associated complications have been reported regarding concurrent endoscopic sinus surgery (ESS) and rhinoplasty procedures. The aim of this study was to evaluate the overall safety of these concurrent procedures in our experience.

A chart review was performed on 48 consecutive patients undergoing concurrent ESS and rhinoplasty between January 1998 and January 2005 with a mean follow-up of 12 months. The extent of surgical procedures, revisions required, and postoperative complications were documented.

Thirty-one (65%) women and 17 (35%) men ranging in age from 16 to 56 years with a mean age of 37 years were included in this study. Forty-five patients (93.7%) underwent a primary rhinoplasty procedure, whereas the other three (6.3%) underwent a revision rhinoplasty. Four patients required minor rhinoplasty revision procedures for a rhinoplasty revision rate of 4/48 or 8.3%. Complications noted in three separate cases included partial nasal obstruction, pain near osteotomy site, and localized infection for a complication rate of 3/48 or 6.3%.

In this study, rhinoplasty revisions did not appear to be related to the fact that ESS was performed at the same time as rhinoplasty. In addition, the only complication possibly attributed to a combined approach was a postoperative infection that developed in an insulin-dependent diabetic patient who underwent a rhinoplasty for functional reasons. Consequently, we recommend screening patients with poor wound healing factors in addition to those with acute exacerbations of chronic rhinosinusitis or severe chronic rhinosinusitis before performing concurrent ESS and rhinoplasty. In our experience, complications noted during concurrent ESS and rhinoplasty were minor, indicating the overall safe nature of this combined procedure when performed in appropriate patients.