The Use of Hyperbaric Oxygen Therapy in Secondary Rhinoplasty

Overview

Revision rhinoplasty sometimes has to be done on skin whose blood supply has already been damaged by earlier surgery or infection. Hyperbaric oxygen therapy raises the oxygen carried in the blood by having the patient breathe oxygen at increased pressure. This is a brief review chapter. The abstract sets out where the author uses the treatment and what he combines it with. It reports no patient numbers, protocols or outcome data.

Sections of note

• Situations named: complex rhinoplasty defects with compromised vascularity, use of flaps or composite grafts, and cases with prior infection.
• The author states outcomes are maximised when the therapy is combined with nanofat and the Silastic healing chamber.
• Safety and comfort during administration are called critical.
• The abstract gives no session counts, pressures, durations, complication rates or comparison group.

What it means for a patient

• This applies to a small group: revision patients whose skin or grafts are at risk of not healing, not to routine rhinoplasty.
• The claims rest on one surgeon's practice as summarised in a review chapter, with no data given here.
• Hyperbaric treatment means repeated sessions in a pressurised chamber, a commitment in time and cost the abstract does not quantify.

Why this paper matters

It documents an adjunct used at the difficult end of revision surgery, where skin loss is the feared outcome. Whether the therapy changes healing rates, and at what dose, is not addressed by this abstract.

Terms

• Hyperbaric oxygen therapy (HBOT): breathing oxygen at above-normal pressure to raise oxygen delivery to tissue.
• Secondary rhinoplasty: another term for revision surgery on a previously operated nose.
• Compromised vascularity: reduced blood supply, which puts skin and grafts at risk of dying.
• Composite graft: a graft carrying more than one tissue type, such as skin with cartilage.
• Nanofat: finely processed fat injected to improve skin quality and healing.
• Silastic healing chamber: a silicone device used to protect and support healing tissue.