Functional and Aesthetic Outcomes of Let Down Dorsal Preservation Rhinoplasty

Background: Preservation rhinoplasty is a re-emerging technique that lacks data on functional and aesthetic outcomes. Objective: To measure the change in patient-reported nasal aesthetic perception, nasal breathing, and sleep and compare outcomes between two different septal cartilage manipulation techniques among patients undergoing preservation rhinoplasty. Methods: Functional and aesthetic outcomes of a let down dorsal preservation rhinoplasty using either the modified subdorsal strip method (MSSM) or subdorsal Z-flap are assessed pre- and postoperatively using the validated assessment tools Nose Obstruction Symptom Evaluation (NOSE), Sinonasal Outcome Test (SNOT-22), Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS), and Epworth Sleepiness Scale (ESS). Results: Fifty-two patients, 40 women and 12 men ages 15-69 years, underwent dorsal preservation rhinoplasty and the majority reported at 1, 3, 6, and 12 months postoperatively significant improvement based on a paired t-test in NOSE, SNOT-22, SCHNOS, and ESS scores except for ESS scores at 6 and 12 months. No significant difference based on a two-sample t-test was observed between the MSSM and Z-flap techniques implemented. Conclusion: Let down dorsal preservation rhinoplasty with either the MSSM or Z-flap cartilage manipulation technique can achieve significant improvement in nasal aesthetics, nasal breathing, and sleep according to patient responses on validated assessment tools.