Functional Outcomes of Dorsal Preservation Rhinoplasty: A Systematic Review and Meta-analysis

Overview

A concern with preservation rhinoplasty is that lowering the intact bridge may narrow the airway. The authors searched for studies that reported original quantitative data with validated functional measures (NOSE, SCHNOS-O, VAS-F, SNOT-22 or rhinometry), with or without a structural comparison group, and pooled the results.

Sections of note

• 22 studies with 2,058 patients met inclusion criteria.
• Controlled studies showed no significant difference in function between preservation and structural techniques.
• Uncontrolled studies showed improvement from baseline after preservation surgery.
• Only validated outcome instruments or objective rhinometry qualified for inclusion.
• Co-author Saban is one of the originators of modern dorsal preservation.

What it means for a patient

• Based on this pooled evidence, preservation rhinoplasty does not worsen breathing relative to structural rhinoplasty.
• Both approaches improved patient-reported breathing scores.
• The pooled data come mostly from observational studies, so the finding is reassuring rather than definitive.

Why this paper matters

It is the largest pooled analysis to date focused on function rather than appearance in preservation rhinoplasty. Limits: the abstract gives no effect sizes, heterogeneity or follow-up durations; studies are mostly uncontrolled.

Terms

• Functional outcome: how well the nose breathes, as opposed to how it looks.
• NOSE: Nasal Obstruction Symptom Evaluation, a 0-100 patient questionnaire.
• SCHNOS-O: the obstruction subscale of the SCHNOS questionnaire.
• VAS-F: a visual analogue scale rating of breathing.
• Rhinometry: instrument-based measurement of nasal airflow or airway dimensions.