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Analysis of Nasal Obstruction Patterns Following Reductive Rhinoplasty.

Tyler Stephen Okland¹, Cherian Kandathil¹, Akshay Sanan¹

¹Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.

Aesthetic Plastic Surgery

|August 30, 2019

Summary

Cosmetic rhinoplasty, using airway preservation techniques, does not increase nasal obstruction risk. Patient-reported outcomes show initial swelling, with subsequent improvement in breathing and satisfaction.

Keywords:

Cosmetic rhinoplasty NOSE Nasal obstruction Patient-reported outcome measures SCHNOS

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Area of Science:

Plastic Surgery
Otolaryngology
Patient-Reported Outcomes

Background:

Cosmetic rhinoplasty may cause breathing issues, often assessed clinically.
Limited research uses patient-centered tools to evaluate post-rhinoplasty breathing disturbances.

Purpose of the Study:

To determine the incidence and severity of nasal obstruction after cosmetic rhinoplasty.
To utilize patient-centered, disease-specific instruments for outcome assessment.

Main Methods:

Retrospective review of 68 adult cosmetic rhinoplasty patients (Jan 2017-Jan 2019).
Data collected included demographics, Nasal Obstruction and Symptom Evaluation (NOSE), and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scores.
Scores were compared preoperatively and across postoperative visits, with analysis by surgical technique (hump reduction, tip correction, or both).

Main Results:

Mean SCHNOS and NOSE scores initially increased post-surgery but decreased at subsequent visits.
No significant increase in SCHNOS or NOSE scores was observed for any surgical subgroup.
Only two patients reported higher than baseline NOSE scores at the most recent follow-up.

Conclusions:

Reductive rhinoplasty, with modern airway preservation, is not linked to increased breathing obstruction.
Initial postoperative symptom increases likely due to swelling, resolving with time.
NOSE and SCHNOS are effective patient-centered tools for evaluating nasal obstruction post-cosmetic rhinoplasty.