Comparison of Patient-Reported Outcomes Between Dorsal Preservation and Conventional Dorsal Hump Reduction Rhinoplasty: A Systematic Review and Meta-Analysis.

BACKGROUND: Recently, improvements in dorsal preservation rhinoplasty have been reported to minimize swelling, reduce scarring, and the aesthetic lines of the nasal dorsum. METHODS: Sourcing studies from six databases, the change in patient-reported scores for cosmetic satisfaction (-C) (using a visual analogue scale [VAS] and the Standardized Cosmesis and Health Nasal Outcomes Survey [SCHNOS]) and nasal obstruction severity (-O) (using a VAS, the SCHNOS, and the Nasal Obstruction Symptom Evaluation [NOSE]) related to the presence of a nasal anatomical deformity were recorded from baseline (before treatment) to post-treatment and compared between an intervention group (dorsal preservation rhinoplasty) and a conventional group (conventional dorsal hump reduction rhinoplasty). The mean difference was chosen to calculate effect sizes of patient-reported outcomes. RESULTS: Data for meta-analysis were retrieved for six studies with a total of 753 patients. The cosmetic satisfaction of patients was significantly greater in the intervention group versus the conventional group (VAS-C: -0.5215 [-0.9616; -0.0814]/SCHNOS-C: 1.9385 [0.1648-3.7123]). There was no significant difference in nasal obstruction scores between the intervention and conventional groups (VAS-O: -0.1997 [-0.5337; 0.1343]/SCHNOS-O: 0.5204 [-1.0096; 2.0504]/NOSE: -3.7884 [-10.2381; 2.6612]). According to the timing of measurement, the intervention group maintained a better improvement in cosmetic satisfaction (VAS-C and SCHNOS-C) until six months postoperation (early), but there was no significant difference thereafter. CONCLUSION: Based on the patient-reported cosmetic or functional benefits, although dorsal preservation led to better cosmetic results in the early follow-up period, the results after six months were similar in the two groups. The two techniques led to similar functional improvements in nasal obstruction at one year of follow-up. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Duke Scholars

Author David W Jang Rhinology and Skull Base Surgery