A Bibliometric Analysis of the 100 Most-cited Articles in Rhinoplasty

Overview

Citation counts are used as a rough measure of which papers shaped a field. The authors pulled the 100 most-cited rhinoplasty articles from Web of Science in October 2015 and recorded their journal, year, citation counts, article type, level of evidence, country, focus, use of outcome measures, and funding. The result describes what the foundational rhinoplasty literature actually consists of.

Sections of note

• Search covered January 1864 through September 2015; extraction done in October 2015.
• Citations per article ranged from 61 to 276, or 1.5 to 12.1 average citations per year.
• Surgical technique was the focus of 53% of articles; of those, 75% concerned reconstruction.
• The United States produced 72% of the articles, the United Kingdom 8%.
• All 100 appeared in 20 journals; Plastic and Reconstructive Surgery contributed the most at 57.
• No article achieved level 1 or level 2 evidence on the 2011 Oxford CEBM scale; 64 were level 4.
• Case series were the most common methodology at 37; only 21 used validated outcome measures; 29% appeared in Selected Readings in Plastic Surgery; 89% were unfunded.

What it means for a patient

• The most influential rhinoplasty papers are largely surgeon experience reports, not randomized trials.
• Fewer than a quarter measured results with a validated tool, so claims about technique superiority rest on weak footing.
• The literature is heavily concentrated in one country and a small number of journals.
• This analysis counts citations, which measures influence rather than correctness or quality.

Why this paper matters

These 100 papers underpin current teaching and surgical decision making, so their evidence level sets a ceiling on how well grounded standard practice is. The authors call for validated objective assessment tools. Whether newer rhinoplasty research has raised that evidence level is not answered here.

Terms

• Bibliometric analysis: Counting and classifying publications to measure a field.
• Citation: A reference to an article by a later paper, used as a proxy for influence.
• Level of evidence: A ranking of study designs, with randomized trials highest and case series and expert opinion lowest.
• Case series: A report describing a group of patients treated the same way, with no comparison group.
• Validated outcome measure: A questionnaire or score tested to show it reliably measures what it claims.