Dataset Information

Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty.

ABSTRACT:

Importance

Significant nasal septal deviation may require complex reconstruction to achieve complete correction. Subtotal septal reconstruction is a method for addressing deviations in the L-strut.

Objectives

To review the long-term outcomes of subtotal septal reconstruction and provide objective evidence of functional and aesthetic improvement.

Design, setting, and participants

This medical record review obtained data on 144 patients who underwent subtotal septal reconstruction from September 1, 2008, to September 1, 2013. Data analysis was performed from September 1, 2013, to September 1, 2014.

Main outcomes and measures

Functional outcomes were measured using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and objective aesthetic outcomes were measured using 3-dimensional (3-D) stereophotogrammetry. Follow-up times were classified as time point 1 (TP1; preoperative), time point 2 (TP2; early postoperative), and time point 3 (TP3; final postoperative).

Results

Of the 144 patients who underwent subtotal septal reconstruction, 104 (72.2%) were female; the mean (SD) age was 37.3 (13.7) years; 57 underwent primary septorhinoplasty; and 87 (60.5%) underwent revision septorhinoplasty. The NOSE scores improved in all 5 categories of nasal obstruction, with mean (SD) survey completion at 270 (260.1) days. Aesthetic results were measured with 3-D imaging after a mean (SD) follow-up of 613.5 (434.4) days postoperatively. No statistically significant loss was found in mean (SD) nasal length over time (TP2 to TP 3, -0.16 [1.36] mm; 95% CI, -0.54 to 0.22 mm; P?=?.41) or between mean (SD) postoperative loss of projection (TP2 and TP3, -0.19 [0.92] mm, 95% CI, -0.45 to 0.07 mm; P?=?.17). An increase in mean (SD) rotation (nasolabial angle) generated with septorhinoplasty (4.24° [11.08°]; 95% CI, 1.14°-7.34°; P?=?.01) and a mean (SD) decrease in rotation detected during postoperative healing (-2.63° [6.96°]; 95% CI, -4.63° to -0.63°; P?=?.01) were found. Although measurement of symmetry was improved in the early postoperative period (TP1 to TP2, -0.16 [1.26] mm; 95% CI, -0.52 to 0.20 mm; P?=?.40), this finding did not become statistically significant until the final measurement (TP1 to TP3, -0.43 [1.07] mm; 95% CI, -0.73 to -0.13 mm; P?=?.007; TP2 to TP3, -0.28 [0.87] mm; 95% CI, -0.53 to -0.03 mm; P?=?.03). A mean (SD) decrease in columellar show was achieved with surgery (-0.66 [1.37] mm; 95% CI, -1.05 to -0.27 mm; P?=?.001). No statistically significant change was found in the alar-columellar association from TP2 to TP3 in this patient population, confirming no unwanted alar or columellar retraction over time (0.10 [0.61] mm; 95% CI, -0.07 to 0.27 mm; P?=?.25). A total of 114 patients (79.2%) required costal cartilage harvest for adequate reconstruction.

Conclusions and relevance

Subtotal septal reconstruction yields improved functional and aesthetic outcomes and has the potential to be a useful tool for the rhinoplasty surgeon in the treatment of severe septal deviation.

Level of evidence

SUBMITTER: Asher SA

PROVIDER: S-EPMC5833668 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty.

Asher Scott A SA Kakodkar Akta S AS Toriumi Dean M DM

JAMA facial plastic surgery 20180101 1

<h4>Importance</h4>Significant nasal septal deviation may require complex reconstruction to achieve complete correction. Subtotal septal reconstruction is a method for addressing deviations in the L-strut.<h4>Objectives</h4>To review the long-term outcomes of subtotal septal reconstruction and provide objective evidence of functional and aesthetic improvement.<h4>Design, setting, and participants</h4>This medical record review obtained data on 144 patients who underwent subtotal septal reconstru ...[more]

PMID: 28910438

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Dataset Information

Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty.

Importance

Objectives

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Level of evidence

Publications

Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty.

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