Quality of Life and Symptoms Before and After Nasal Septoplasty With or Without Turbinoplasty Compared With Control Individuals in Saudi Arabia.

OBJECTIVES: Nasal septal deviation is a common health issue that can significantly impact the quality of life. Although nasal septoplasty is commonly performed in Otolaryngology practice, its effectiveness has been questioned. This was the first study to assess disease-specific quality of life in patients undergoing nasal septoplasty with or without turbinoplasty in Saudi Arabia. METHODS: This was a prospective observational study of patients undergoing nasal septoplasty with or without turbinoplasty for nasal obstruction due to septal deviation with or without inferior turbinate hypertrophy. Nasal Obstruction Symptom Evaluation (NOSE) scores were collected preoperatively and 3 months postoperatively and were compared with controls. RESULTS: This study involved 200 subjects, including 40 patients in the case group and 160 individuals in the control group. The mean preoperative and 3-month postoperative NOSE scores of the case group were (58.4±23.7 and 15.0±18.6, P <0.001), respectively. However, the postoperatively NOSE score did not reach NOSE score in control group (13.28±8.13, P =0.377). All nasal symptoms statistically and clinically improved postoperatively. There were no significant differences in NOSE score changes among cases preoperatively and postoperatively according to age, sex, or the presence of allergic rhinitis or asthma. CONCLUSIONS: Nasal septoplasty with or without turbinoplasty leads to improvements in disease-specific quality of life as assessed by NOSE scores and significantly improved nasal symptoms 3 months after surgery.

Understanding Nasal Valve Compromise in Nasal Airway Obstruction: A New Classification System.

OBJECTIVES: A key aspect of rhinoplasty is integrity of nasal valves area because of its fundamental role in patent nasal airway. furthermore, nasal obstruction is a dominant feature in patient with nasal valves dysfunction (NVD) which can be devastating outcome after rhinoplasty. METHODS: Nonetheless, NVD has been widely investigated regarding their etiologies and management. However, it has been assumed that the anatomical complexity and interplay between its structures causing a confusion for a beginner surgeon to diagnose and treat NVD. This study was approved by the institutional review board of Chosun University Hospital, Gwangju, Korea (2022-11-005). RESULTS: To date, the lack of consensus on nasal valve pathologies and corrective procedures has led to its underestimations during analysis and management. As result, we proposed a classification system based on its affected anatomical part, location, and their management. Thus, implementing a classification system for NVD will help guide the practice of rhinoplasty and introduce a more structured approach. CONCLUSION: This approach will prove useful in expanding our understanding of how important to locate the pathology of NVD and apply the most relevant management options, particularly for a beginner surgeons. LEVEL OF EVIDENCE: V.

Prevalence of Body Dysmorphic Disorder Among Rhinoplasty Candidates: A Systematic Review.

OBJECTIVE: Body dysmorphic disorder (BDD) represents a bridge between the fields of psychiatry and cosmetic surgery. It is a psychiatric disorder involving altered body image and has been associated with cosmetic surgery. Many studies have investigated BDD following rhinoplasty. However, their findings were inconsistent, which prompted us to conduct this systematic review to obtain strong evidence about the prevalence of BDD among rhinoplasty candidates. METHODS: We searched the literature using electronic databases such as PubMed, Scopus, Web of Science, and others using keywords relevant to the study outcomes. We also manually examined the references of the included studies and relevant reviews to look for articles that might have been missed during the electronic search. RESULTS: Nine articles met the inclusion criteria. We identified 7 other relevant articles; since they had been included in a review conducted in 2016, they were not included in the final list of articles. However, they were included in the discussion, and their findings have been compared with ours. The included articles resulted in a total sample of 712 rhinoplasty candidates. The estimated prevalence rates of BDD in these articles ranged from 22% to 52%, which was considered high by all the authors of the included studies. CONCLUSION: The prevalence of BDD among rhinoplasty candidates is high, and adequate management and interventions are needed to reduce it.

Bone and Soft Tissue Nasal Angles Discrepancies and Overlying Skin Thickness: A Computed Tomography Study.

BACKGROUND: The aim of this study was to derive the normal values for bone and soft tissue nasal angles as well as the overlying skin thickness and to attempt to determine the correlation between differences in bone and soft tissue angles and overlying skin thickness in Middle Eastern patients. MATERIALS AND METHODS: Three-dimensional cephalometric analysis was performed for 100 patients who underwent computed tomography of the paranasal sinuses. The nasofrontal angle, pyramidal angle-nasal root, pyramidal angle-tip of the nasal bone, and overlying skin thickness were measured, and the results were analyzed according to sex, age, and body mass index (BMI). RESULTS: All soft tissue angles were significantly larger than the bone angles, with the mean difference being 11.62°, 30.80°, and 27.05° for the nasofrontal angle (P = 0.000), pyramidal angle-nasal root (P = 0.000), and pyramidal angle-tip of the nasal bone (P = 0.000), respectively. The mean overlying skin thickness was 3.89 ± 1.48 mm at the nasion, 1.16 ± 0.6 mm at the rhinion, and 2.93 ± .97 mm at the nasal tip. Differences in the nasofrontal angle were strongly correlated with the skin thickness at the nasion (P = 0.001). CONCLUSION: A simple clinical exam of the soft tissue nasal angles does not reflect the underlying bone angles that will be encountered during rhinoplasty. BMI does not influence nasal shape, and rhinoplasty surgery should take into account the ethnic group, age, and sex of the patient. Surgeons should leave a minor skeletal hump at the end of the nasal bone for Middle Eastern patients. LEVEL OF EVIDENCE IV: 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 .