Comparison of Patient-Reported Outcomes Between Dorsal Preservation and Conventional Dorsal Hump Reduction Rhinoplasty: A Systematic Review and Meta-Analysis

Kim DH, Jang DW, Hwang SH.

PubMed 40195129 Publisher (DOI)Free full text (PMC)

What this paper says

Pooling six studies with 753 patients, dorsal preservation gave better patient-rated appearance than conventional hump reduction in the first six months, with no difference thereafter and no difference in breathing at any point.

Overview

The Korean authors searched six databases for studies comparing patient-reported cosmetic (VAS-C, SCHNOS-C) and obstruction (VAS-O, SCHNOS-O, NOSE) scores between dorsal preservation and conventional hump reduction, and pooled mean differences from baseline to follow-up.

Sections of note

Six studies, 753 patients.
Cosmetic satisfaction favoured preservation: VAS-C -0.5215 (95% CI -0.9616 to -0.0814); SCHNOS-C 1.9385 (0.1648 to 3.7123).
Obstruction scores did not differ: VAS-O -0.1997; SCHNOS-O 0.5204; NOSE -3.7884, all with confidence intervals crossing zero.
By timing: preservation held a cosmetic advantage up to six months, then no significant difference.
Level of Evidence III.

What it means for a patient

Preservation patients tended to be happier with their appearance early, likely reflecting less swelling and irregularity while healing.
By six months to a year, the two approaches gave equivalent results for both looks and breathing.
The pooled studies are observational, so surgeon selection of technique by nose type could explain part of the early difference.

Why this paper matters

It quantifies the early-versus-late pattern that individual studies had hinted at. Limits: six studies, heterogeneity, non-randomised source data.

Terms

Dorsal preservation rhinoplasty: lowering the intact bridge instead of removing the hump.
Conventional hump reduction: removing the bony and cartilaginous hump and rebuilding the middle vault.
VAS-C / VAS-O: visual analogue ratings of appearance and obstruction.
SCHNOS: a validated nasal questionnaire with cosmetic and obstruction subscales.
Mean difference: the pooled average difference between groups in the score's own units.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: Recently, improvements in dorsal preservation rhinoplasty have been reported to minimize swelling, reduce scarring, and the aesthetic lines of the nasal dorsum.

Methods: Sourcing studies from six databases, the change in patient-reported scores for cosmetic satisfaction (-C) (using a visual analogue scale [VAS] and the Standardized Cosmesis and Health Nasal Outcomes Survey [SCHNOS]) and nasal obstruction severity (-O) (using a VAS, the SCHNOS, and the Nasal Obstruction Symptom Evaluation [NOSE]) related to the presence of a nasal anatomical deformity were recorded from baseline (before treatment) to post-treatment and compared between an intervention group (dorsal preservation rhinoplasty) and a conventional group (conventional dorsal hump reduction rhinoplasty). The mean difference was chosen to calculate effect sizes of patient-reported outcomes.

Results: Data for meta-analysis were retrieved for six studies with a total of 753 patients. The cosmetic satisfaction of patients was significantly greater in the intervention group versus the conventional group (VAS-C: -0.5215 [-0.9616; -0.0814]/SCHNOS-C: 1.9385 [0.1648-3.7123]). There was no significant difference in nasal obstruction scores between the intervention and conventional groups (VAS-O: -0.1997 [-0.5337; 0.1343]/SCHNOS-O: 0.5204 [-1.0096; 2.0504]/NOSE: -3.7884 [-10.2381; 2.6612]). According to the timing of measurement, the intervention group maintained a better improvement in cosmetic satisfaction (VAS-C and SCHNOS-C) until six months postoperation (early), but there was no significant difference thereafter.

Conclusion: Based on the patient-reported cosmetic or functional benefits, although dorsal preservation led to better cosmetic results in the early follow-up period, the results after six months were similar in the two groups. The two techniques led to similar functional improvements in nasal obstruction at one year of follow-up.

Level Of Evidence Iii: 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 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).