Gender specific considerations in septorhinoplasty, a retrospective observational study and review of the literature.

Introduction: In our service experience, we found we had a high proportion of male patients undergoing septorhinoplasty. This encouraged us to research gender specific differences in anatomy, surgical techniques, expectations and outcomes. Methods: We performed a retrospective chart review of patients who have had rhinoplasty surgery under a single otolaryngology consultant with a special interest in rhinoplasty. Patient information and results of the 10-Item Standardized Cosmesis and Health Nasal Outcomes Survey for Functional and Cosmetic Rhinoplasty pre and post-surgery were collected. Results: There was no statistically significant difference in the mean pre-operative symptom (29.31 vs 32.29 p = 0.559), change in symptom (23.25 vs 24.14 p = 0.827) or satisfaction scores (8.69 vs 7.29 p = 0.089) between male and female patients. A discussion on gender specific anatomical features and deformities is presented. Conclusion: All patients reported improved symptoms and high levels of satisfaction. Careful patient counselling and patient-specific surgical planning help to achieve optimal outcomes.

Epistaxis in the Sars-CoV-2 Era

Introduction Epistaxis was the third most common unscheduled ENT surgical intervention in Ireland in 2019. Otorhinolaryngologists are exposed to a high viral reservoir of Sars-CoV-2, as they are dealing with pathology in the upper respiratory tract. Risk analysis is required to minimise nosocomial transmission. Methods A prospective audit of epistaxis management in the outpatients at a tertiary hospital was undertaken pre pandemic. A retrospective review of patients records during the Sars-CoV-2 pandemic. Comparative analysis was utilised to assess outcomes. Results Pre Sars-CoV-2 analysis revealed 14 patients (70%) were manged with rigid endoscopy compared to one (5%) interpandemic. Cauterization treated 20 patients (100%) pre pandemic and four patients (20%) interpandemic. Nasal packing modality differed in that 13 patients (65%) were treated with Nasopore pre pandemic and 14 (70%) with Rapid Rhino interpandemic. This exhibited a paradigm shift in that 18 (90%) patients were managed conservatively with nasal packing interpandemic. Conclusion A paradigm shift in the management of Epistaxis during the pandemic has led to treatment which is less invasive, has less morbidity for the patient, requires less hospital admissions and lessens nosocomial transmission of the Sars-CoV-2. Further study is required given the advent of vaccines and development of various strains Sars-CoV-2.