Satisfaction in rhinoplasty: the possible impact of anxiety and functional outcome.

BACKGROUND: Rhinoplasty is a complex but commonly applied surgical procedure. Patient satisfaction is the least discussed but one of the most important determinants of surgical success. OBJECTIVES: Evaluation of the patient satisfaction together with surgeon satisfaction were the main goals of this study. The roles of anxiety, gender, age and follow-up period were also studied. PATIENTS AND METHODS: 53 eligible patients operated by the first two authors within the previous 2 years were enrolled in the study. The medical records were reviewed for demographic data as well as the details of the surgical procedure. Functional and esthetic satisfactions of the patients were evaluated by VAS and ROE respectively. Surgeon satisfaction was evaluated by VAS in crosswise manner. Anxiety was measured by STAI_s and STAI_t scales. RESULTS: The analysis concerning esthetic results as well as functional results did not reveal any significant difference between the two surgeons (p = 0.132, p = 0.43 respectively). ROE scores were significantly different among patients with "good" and "very good" functional results. The difference between surgeon satisfaction and patient satisfaction was found to be insignificant (p = 0.273). Correlation analysis yielded a positive correlation between STAI_I and STAI_II (Pearson r = 0.335, p = 0.014) but not between STAI scores and ROE scores. Moreover, there was no relation between anxiety scores and the functional results. Likely, gender as well as age, follow-up, and surgical technique were not found to have any effect on patient satisfaction either. CONCLUSION: Patient satisfaction is preferential in rhinoplasty. In our patient series, patient satisfaction was shown to be correlated with functional outcome but not with surgeon satisfaction. Anxiety was not found to have a significant impact on results of rhinoplasty. Our results should be interpreted cautiously keeping in mind that our patients' primary drive for rhinoplasty was functional.

Facial, cervical, and mediastinal emphysema of the clarinet player: case report.

BACKGROUND: Cervicofacial emphysema may arise due to the leakage of air from a defect in the aerodigestive tract to the fascial layers of neck and face. Rarely, it may be caused by insufflation of air through the Stensen's duct. CASE REPORT: We present a case with diffuse facial, cervical and mediastinal emphysema due to playing a wind instrument immediately after a facial trauma. There was no mucosal defect or laceration noticed by examination which could explain the origin of the emphysema. Despite the widespread cervicofacial emphysema with mediastinal involvement, the patient significantly improved within 48 hours without any intervention. CONCLUSION: Even though cervicofacial emphysema ameliorates spontaneously, increased care must be taken, especially when there is pneumomediastinum and/or pneumothorax.