Functional and Aesthetic Outcomes of Septal Reconstructions: Results of a Prospective Longitudinal Outcome Study

Abstract

In order to correct severe septal deformities, complete septal reconstruction is often required to achieve the desired functional and aesthetic results. Several different techniques have been described. Systematic evaluation of the long-term results is crucial to assess and improve the quality of these surgical techniques. A custom-built dashboard (the rhinoplasty health care monitor [RHM]) was used for prospective and longitudinal outcome evaluation of the septal reconstruction. The RHM includes the Nasal Obstruction Symptom Evaluation (NOSE) scale for nasal obstruction and the Utrecht Questionnaire (UQ) for aesthetic outcome results. In total, 58 patients were included for septal reconstructive surgery. The mean preoperative NOSE scale scores decreased from 67.8 ± 19.1 to 12.2 ± 17.5, 1 year after surgery. Mean preoperative UQ scores went from 12.3 ± 6.4 to 6.2 ± 2.7. The beneficial functional and aesthetic effects of the techniques that we currently use to reconstruct the septum are efficient in terms of function and aesthetics.

Keywords

septal reconstruction - outcomes - PROM - rhinoplasty

Publication History

Accepted Manuscript online:
08 December 2022

Article published online:
02 February 2023

• References

• 1 Heppt W, Gubisch W. Septal surgery in rhinoplasty. Facial Plast Surg 2011; 27 (02) 167-178
• 2 Gubisch W, Hacker S, Neumann J, Haack S. 40 years of total extracorporeal septal reconstruction: the past, present, and future. Plast Reconstr Surg 2020; 146 (06) 1357-1367
• 3 Gubisch W. Twenty-five years experience with extracorporeal septoplasty. Facial Plast Surg 2006; 22 (04) 230-239
• 4 Toriumi DM. Subtotal septal reconstruction: an update. Facial Plast Surg 2013; 29 (06) 492-501
• 5 Asher SA, Kakodkar AS, Toriumi DM. Long-term outcomes of subtotal septal reconstruction in rhinoplasty. JAMA Facial Plast Surg 2018; 20 (01) 50-56
• 6 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310 (20) 2191-2194
• 7 Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130 (02) 157-163
• 8 Lipan MJ, Most SP. Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plast Surg 2013; 15 (05) 358-361
• 9 Lohuis PJFM, Hakim S, Duivesteijn W, Knobbe A, Tasman AJ. Benefits of a short, practical questionnaire to measure subjective perception of nasal appearance after aesthetic rhinoplasty. Plast Reconstr Surg 2013; 132 (06) 913e-923e
• 10 van Zijl FVWJ, Lohuis PJFM, Datema FR. The rhinoplasty health care monitor: using validated questionnaires and a web-based outcome dashboard to evaluate personal surgical performance. Facial Plast Surg Aesthet Med 2022; 24 (03) 207-212
• 11 Spataro EA, Saltychev M, Kandathil CK, Most SP. Outcomes of extracorporeal septoplasty and its modifications in treatment of severe l-strut septal deviation: a systematic review and meta-analysis. JAMA Facial Plast Surg 2019; 21 (06) 542-550
• 12 Spataro E, Most SP. Measuring nasal obstruction outcomes. Otolaryngol Clin North Am 2018; 51 (05) 883-895
• 13 Rhee JS, Weaver EM, Park SS. et al. Clinical consensus statement: Diagnosis and management of nasal valve compromise. Otolaryngol Head Neck Surg 2010; 143 (01) 48-59
• 14 Ching S, Thoma A, McCabe RE, Antony MM. Measuring outcomes in aesthetic surgery: a comprehensive review of the literature. Plast Reconstr Surg 2003; 111 (01) 469-480 , discussion 481–482
• 15 Cannon DE, Rhee JS. Evidence-based practice: functional rhinoplasty. Otolaryngol Clin North Am 2012; 45 (05) 1033-1043