Which Lighting Option Is the Best for Photography in Rhinoplasty?

Overview

Photography is used for planning and for follow up in rhinoplasty, and the type and position of lighting can change how nasal contours and measurements appear. The study compared pictures taken under three lighting settings and at two light angles, and checked those against direct measurements taken with a caliper on the patients themselves.

Sections of note

• Standardized frontal photographs of 10 patients taken in a studio.
• Three lighting settings were used: the camera's built in flash, two strobe flashes, and two continuous LED lights, placed at 30 to 45 degrees to the patient.
• All images were uploaded to Rhinobase 2.0 for measurement.
• In five subjects, direct measurements were taken with a Vernier caliper and compared with the computer measurements.
• Excluding the single flash, no relation was found between strobe lights at 30 and 45 degrees, or between LED lights at 30 and 45 degrees, for tip width, base bony width, dorsum width, interalar width and nasal length.
• A statistically significant difference was found when the angle changed from 30 to 45 degrees for tip width, interalar width and nasal length.
• Two LED continuous lights and two strobe lights gave similar results.
• Photographs taken at 45 degrees gave values closest to the direct measurements on the patient.

What it means for a patient

• Measurements taken from clinical photographs vary with lighting angle, which affects planning and before and after comparisons.
• The type of light source, LED or strobe, mattered less than where it was placed.
• Only 10 patients were photographed and only 5 had direct measurements for comparison.
• This concerns documentation accuracy, not surgical results.

Why this paper matters

Rhinoplasty results are judged and published largely through photographs, and measurement from those photographs is used in research. This study shows the lighting angle changes some of those measurements. Whether standardizing at 45 degrees would change published outcome comparisons is not addressed.

Terms

• Strobe flash: a studio light that fires a brief burst.
• LED continuous light: a steady light source rather than a flash.
• Vernier caliper: a hand instrument that measures distance directly and precisely.
• Interalar width: the distance across the outer edges of the nostrils.
• Rhinobase: software used to store and measure rhinoplasty photographs.