Cone-Beam Computed Tomography: A User-Friendly, Practical Roadmap to the Planning and Execution of Every Rhinoplasty-A 5-Year Review

Overview

Cone beam computed tomography has spread as a convenient alternative to conventional CT for imaging the face and jaws, but the authors state most rhinoplasty surgeons in both plastic surgery and ear, nose and throat practice are unfamiliar with it. The paper reviews one centre's clinical experience with it over five years and analyses its applications in first time and revision surgery.

Sections of note

• Review of a single centre's broad clinical experience over five years; no patient numbers or outcome data are reported in the abstract.
• Applications analysed include the septum, turbinates, nasal bones, skin thickness and other issues.
• The authors argue for a shift from two dimensional to three dimensional image reconstruction, and for surface contour enhancement.
• The surface image is said to strengthen aesthetic analysis.
• Detailed preview of bony and functional anatomy is said to facilitate surgical planning.
• Spatial views and easy accurate measuring are given as further advantages.
• The stated drawbacks are limited to radiation exposure and cost.

What it means for a patient

• Cone beam CT gives a three dimensional picture of the bone and airway before surgery rather than relying on examination alone.
• It involves radiation exposure, which the authors acknowledge as a drawback.
• No outcomes are reported, so there is no evidence here that imaging improves surgical results.
• Claims of more predictable and efficient surgery are the authors' assessment.

Why this paper matters

Preoperative imaging is not routine in rhinoplasty, and the decision rests on whether the added information changes surgical planning enough to justify radiation and cost. This review makes the case for routine use. Whether outcomes differ with or without imaging has not been tested.

Terms

• Cone beam computed tomography: a three dimensional scan using a cone shaped X ray beam, common in dental and facial imaging.
• Turbinates: the shelves of tissue inside the nose that warm and filter air.
• Maxillofacial: relating to the jaws and face.
• Surface contour enhancement: processing an image to show the shape of the skin surface.
• Radiation exposure: the dose of X rays a patient receives during imaging.