Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 173
Filtrar
1.
Aesthetic Plast Surg ; 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35031825

RESUMO

BACKGROUND: The aim of this study was to systematically evaluate the evidence of surgical outcomes and complications of spreader grafts and autospreader flaps in the context of middle vault reconstruction after dorsal hump removal. MATERIAL AND METHODS: A systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Inclusion and exclusion criteria were based on the population, intervention, comparison, and outcome (PICO) framework. Medline (via PubMed), EMBASE, Cinahl, Scopus, and Web of Science were searched for Clinical and observational studies published in peer-reviewed academic journals with abstracts available that reported rhinoplasty employing either spreader graft or autospreader flap techniques and were published prior to March, 2021. RESULTS: Fifty-two of 1129 relevant studies were included in the qualitative analysis. Thirty-four studies (65.4%) were related to spreader graft (SG), 10 (21.1%) studies of autospreader flap (AF) alone and 8 (13.5%) studies involving both grafts. Meta-analysis was performed on 17 studies reporting change in NOSE scores, with pooled effect of - 23.9 (95% CI, - 26.7 to - 21.1) points. High heterogeneity with I2 = 99%. Summary data showed no differences between groups, AF group versus no graft (p = 0.7578), AF versus SF group (p = 0.9948), and SG group versus no graft (p = 0.6608). CONCLUSION: Based on available data, change in NOSE scores after rhinoplasty was similar in procedures that used spreader graft only or autospreader flap only. 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.

2.
Clin Plast Surg ; 49(1): 111-121, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782129

RESUMO

The crooked nose is a challenging esthetic and functional problem. The surgeon must carefully evaluate baseline facial asymmetry as well as whether deviation stems from the upper third, middle third, or lower third of the nose. Surgical intervention should be tailored accordingly, with techniques geared toward addressing each deviated section. Modified dorsal preservation techniques represent a newer means to address deviations. Operative results must be measured, ideally through patient-reported outcomes measures, to quantify overall success.


Assuntos
Deformidades Adquiridas Nasais , Rinoplastia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Resultado do Tratamento
3.
Clin Plast Surg ; 49(1): 13-22, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782131

RESUMO

Photodocumentation is an essential part of a rhinoplasty surgeon's practice. Preoperative photographs are an indispensable device for patient counseling and surgical planning. Comparison of preoperative and postoperative photographs allow for outcome evaluation, which has a variety of applications-clinical, research, teaching, medicolegal. The ever-evolving technology of photography may seem daunting, but developing a basic understanding of this tool is imperative for a successful rhinoplasty practice. This article reviews the basic photographic principles, equipment, and techniques that are essential to produce high-quality and standardized patient photographs.


Assuntos
Rinoplastia , Humanos , Fotografação
4.
Clin Plast Surg ; 49(1): 23-31, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782137

RESUMO

Nasal airway obstruction is a very common phenomenon that can significantly decrease patients' quality of life. This review article summarizes in an evidence-based fashion the diagnosis and treatment of nasal airway obstruction. The nasal airway may be obstructed at the level of the nasal valve, septum, nasal turbinates, sinonasal mucosa, or nasopharynx. Nasal valve obstruction and septal deviations are usually treated surgically depending on the level of valve obstruction. Isolated turbinate hypertrophy is usually managed medically as part of the treatment of rhinitis, with surgery reserved for cases refractory to medical care. Sinonasal and nasopharyngeal conditions are treated according to the diagnosis.


Assuntos
Obstrução Nasal , Rinoplastia , Humanos , Obstrução Nasal/diagnóstico , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Nasofaringe , Qualidade de Vida
5.
Clin Plast Surg ; 49(1): 97-109, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782143

RESUMO

There has been a resurgence in dorsal preservation rhinoplasty (DPR) caused by theoretic aesthetic and functional advantages compared with conventional hump takedown rhinoplasty. Classically, the push-down and let-down maneuvers have been described for management of the bony nasal vault. There have been a variety of modifications in the septal resection that is a requisite for dorsal lowering in DPR. Partial dorsal preservation techniques, including cartilage-only preservation, have also been described. Although several studies have reported aesthetic and functional success with a variety of techniques, few have used objective or patient-centered subjective measures.


Assuntos
Rinoplastia , Cartilagem , Estética , Humanos , Septo Nasal/cirurgia
6.
Clin Plast Surg ; 49(1): xiii-xiv, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782144
7.
Aesthetic Plast Surg ; 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34845518

RESUMO

BACKGROUNDS: Rhinoplasty necessarily concerns functional and cosmetic aspects, and outcomes of both should be assessed in each patient. There has been a lack in the literature in Italian for a comprehensive tool for assessing both aspects of rhinoplasty. The objective is to translate and validate the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) into Italian. METHODS: Forward and back-translation was used. Content validity was evaluated by experts and by patient interviews. Internal consistency was assessed by a Cronbach's alpha. The structure validity was assessed by an exploratory factor analysis. RESULTS: Cognitive interviews of 10 rhinoplasty patients resulted in a good overall comprehension of the SCHNOS. Of the 411 respondents, 281 (32%) were women, and the average age was 33.6 (11.3) years. The alpha was excellent for both the obstruction domain (SCHNOS-O) (0.90) and the cosmetic domain (SCHNOS-C) (0.94). All the correlations between repeated measures were moderate to very strong. The exploratory factor analysis demonstrated unidimensionality of both the SCHNOS-O and the SCHNOS-C scores. CONCLUSIONS: The SCHNOS was successfully translated and validated in Italian and can be recommended for a clinical use among rhinoplasty patients. 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 .

9.
Artigo em Inglês | MEDLINE | ID: mdl-34185595

RESUMO

Background: The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a validated patient-reported outcome measure that evaluates subjective cosmetic and functional complaints. The goal of this study was to compare scores between patients with and without nasal complaints. Methods: This is a retrospective review of SCHNOS-O (obstructive) and SCHNOS-C (cosmetic) scores in patients presenting for functional or cosmetic concerns between 2019 and 2020. Receiver operating characteristic curve analysis was used to determine the score that best separated symptomatic from asymptomatic patients. SCHNOS scores were also subdivided to define severity of presenting complaints. Results: In total, 414 patients were included. A SCHNOS-O score of 40 differentiated patients with and without nasal obstruction. Patients may be categorized as having mild (<40), moderate (45-70), and severe (75-100) nasal obstruction based on the SCHNOS-O score. A score of 30 on the SCHNOS-C differentiated patients with and without aesthetic concerns. Patients may be categorized as having mild (<33.3), moderate (33.3-66.6), and severe (>66.6) aesthetic distress based on the SCHNOS-C. Conclusion: An understanding of SCHNOS scores that differentiate symptomatic for asymptomatic patients can aid in the preoperative evaluation of rhinoplasty patients.

10.
Artigo em Inglês | MEDLINE | ID: mdl-33970690

RESUMO

Background: Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. Materials and Methods: An 11-item questionnaire was electronically distributed to regional academies/societies representing rhinoplasty surgeons worldwide. Respondent exposure to and use of DPR were assessed based on geographic location. Results: Eight hundred thirty-six responses were received. Despite early publications on DPR originating largely from Western Europe and the United States, Turkey and Mexico have the greatest use of DPR techniques currently. The familiarity across many regions with preservation techniques appear to be secondary to courses and conferences rather than incorporation into training. Mexico demonstrates the greatest exposure to DPR during training. One hundred twenty-five respondents had previously used but abandoned dorsal preservation techniques. Poor results, less predictability, and complications (largely hump recurrence) are cited as common reasons for this. Conclusion: There is variability in the global practice of DPR across regions and this will likely continue to evolve.

14.
Facial Plast Surg ; 37(1): 81-85, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33626587

RESUMO

Classic Joseph hump reduction techniques have been a hallmark of current rhinoplasty practice and teaching. Recently, there has been a renewed global interest in preservation rhinoplasty techniques, although these techniques are not new. The work and techniques of innovative surgeons including Goodale, Lothrop, and Cottle describing preservation concepts from the late nineteenth century and early twentieth century were not as prevalently adopted as open structural approaches. As such, there has been a relative paucity in both research and teaching of preservation techniques-particularly in the United States. A survey of members of the American Academy of Facial Plastic and Reconstructive Surgery and The Rhinoplasty Society (145 respondents) demonstrates that while 15 (10%) of surgeons are not at all familiar with dorsal preservation surgery, 130 (90%) were. In the group that was familiar with dorsal preservation, the majority were only somewhat familiar (84, 65%) with these techniques. Only 11 respondents received any formal training in dorsal preservation techniques during residency or fellowship. 61 (42%) had attended a course or conference in which dorsal preservation techniques were discussed. One-hundred twenty-two survey respondents (84.1%) do not currently implement preservation techniques into their rhinoplasty practice. Twelve (8%) respondents implement it in <25% of cases, 5 (3%) in 25 to 50% of cases, and 6 (4%) in >50% of cases. As research and formal training in preservation rhinoplasty grow, familiarity and implementation of these techniques will likely also grow in the United States.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Bolsas de Estudo , Humanos , Inquéritos e Questionários , Estados Unidos
16.
Laryngoscope ; 131(6): E1830-E1837, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33459395

RESUMO

OBJECTIVES/HYPOTHESIS: To evaluate the lateral nasal wall stability, nasal function, and cosmesis when creating an aesthetically pleasing nasal tip subunit utilizing lateral crus (LC) altering procedures. STUDY DESIGN: Retrospective cohort. METHODS: In this retrospective cohort study, cosmetic rhinoplasty patients undergoing LC procedures with available lateral wall insufficiency (LWI) scores were included. An LWI grading system was used to evaluate internal (zone 1) and external (zone 2) nasal valves objectively. Secondarily, Nasal Obstruction Symptom Evaluation (NOSE) Score, Visual Analog Scale (VAS) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) results were evaluated. Based on the LC intervention, the cohort was divided into six groups: lateral cural strut graft (LCSG), mini-LCSG, lateral crural overlay (LCO) with and without additional support, cephalic trimming, and cephalic turn-in flaps. RESULTS: Subjects undergoing LCO with and without support, LCSG, and mini-LCSG showed significant improvement in zone 1 LWI (P = .042, P = .041, P < .001, and P < .001, respectively), while cephalic trimming and turn-in/hinged flaps had no effect. Subjects undergoing LCO with support and LCSG showed significant improvement in zone 2 LWI (P = .022, P = .004), while LCO without support, mini-LCSG, cephalic trimming, and turn-in flaps showed no effect on LWI. The SCHNOS-C and VAS-C showed significant improvement in all subgroups (P < .05) when comparing pre- to postoperative values. Alar-spanning sutures did not significantly change zone 1 scores but did conceal zone 2 improvements in LCSG and LCO with support groups. CONCLUSIONS: Selected LC procedures are robust techniques for improving tip cosmesis independently without compromising nasal lateral wall stability. Some LC procedures can improve nasal valves patency in tip surgery. Laryngoscope, 131:E1830-E1837, 2021.


Assuntos
Estética , Rinoplastia/métodos , Adulto , Feminino , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Retalhos Cirúrgicos
17.
Aesthet Surg J ; 41(7): NP728-NP734, 2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-33388763

RESUMO

BACKGROUND: Although prior studies have identified a low risk of venous thromboembolism (VTE) in rhinoplasty, these studies are limited by small samples and associated risk factors remain unknown. OBJECTIVES: The aim of this study was to discern the incidence of VTE following rhinoplasty in a large patient population through analysis of a nationwide insurance claims database. METHODS: This study involved a population-based retrospective analysis of insurance claims made by patients who underwent rhinoplasty between 2007 and 2016. Established risk factors for VTE, demographic data, procedural details, and absolute incidence of VTE were collected. RESULTS: We identified a total of 55,287 patients who underwent rhinoplasty from 2007 to 2016. Mean age [standard error of the mean] was 38.74 [0.06] years (range, 18-74 years), and 54% were female. The overall incidence of VTE was 111, of which 70 were DVT and 41 were PE. From multivariate regression analysis, previous VTE (odds ratio [OR], 52.8; 95% confidence interval [CI], 35.2-78.6; P < 0.0001), peripherally inserted central catheter (PICC)/central line placement (OR, 19.6; 95% CI, 9.8-153; P < 0.05), rib graft (OR, 4.6; 95% CI, 2.3-8.5; P < 0.0001), age 41 to 60 years (OR, 2.65; 95% CI, 1.7-4.3; P < 0.01), inflammatory bowel disease (IBD) (OR, 2.6; 95% CI, 1.0-5.5; P < 0.05), and age 61 to 74 years (OR, 2.4; 95% CI, 1.2-4.8; P < 0.05) were associated with an increased risk of VTE. CONCLUSIONS: We demonstrate a low overall incidence of VTE in rhinoplasty patients. Previous VTE, PICC/central line, advancing age, IBD, and intraoperative rib graft harvest were most strongly associated with VTE in this population cohort.


Assuntos
Rinoplastia , Tromboembolia Venosa , Trombose Venosa , Adolescente , Adulto , Idoso , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Retrospectivos , Rinoplastia/efeitos adversos , Fatores de Risco , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia , Adulto Jovem
18.
Laryngoscope ; 131(7): E2387-E2392, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33405290

RESUMO

OBJECTIVES: To determine whether hearing aid (HA) use affects social perceptions of general public adults and age-matched peers and if so, determine if effects are modulated by lack of societal representation of pediatric HAs. METHODS: A 10-year-old boy was presented in six photographic conditions with and without HAs and eyeglasses (a worn sensory aid with wider societal representation). HAs were presented in neutral skin tone and bright blue colors. Photographic conditions were embedded into web-based surveys with visual analog scales to capture social perceptions data and sourced to 206 adults (age 18-65) and 202 peers (age 10) with demographic characteristics representative of the general US population. Mean differences in scores for each condition compared to control images were computed using two-tailed t-tests. RESULTS: In both adult and child respondents, HAs were associated with decreased athleticism, confidence, health, leadership, and popularity. Glasses were associated with decreased athleticism and popularity but increased intelligence, overall success, and in the child respondents, friendliness. When worn in combination, the beneficial effects of glasses were mitigated by brightly colored but not neutrally colored HAs. CONCLUSION: Negative effects of pediatric HAs on social perceptions may be influenced by poor societal representation of HAs. These results suggest that greater representation of pediatric HAs is necessary to make society more inclusive for children with hearing loss. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E2387-E2392, 2021.


Assuntos
Auxiliares de Audição/psicologia , Perda Auditiva/reabilitação , Infuência dos Pares , Percepção Social , Adolescente , Adulto , Idoso , Criança , Óculos/psicologia , Feminino , Perda Auditiva/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
20.
Facial Plast Surg Aesthet Med ; 23(5): 350-356, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33054404

RESUMO

Objectives/Hypothesis: The face is a major communicator of gender identity. Transfeminine individuals report debilitating quality-of-life deficits as a result of their gender dysphoria, which may be addressed with feminizing therapies. We aimed to quantify the potential impact of facial gender dysphoria experienced by transfeminine patients, as well as associated treatments, including feminizing facial gender surgery, through validated health state utility measures. Methods: A transfeminine patient volunteer who underwent head and neck gender-affirming treatments was consented for research use of perioperative photographs. These media aided in the description of two transfeminine health states, pre- and postfacial feminization facial gender dysphoria. Monocular blindness and binocular blindness were two health state controls. General population adults rated these four health states through visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO), which were used to calculate the quality-adjusted life years (QALYs). Results: Survey respondents totaled 206 with a mean (standard deviation [SD]) age of 35.8 (11.9) years. Mean (SD) health utility measures included 0.75 (0.22) QALYs for VAS, 0.82 (0.19) QALYS for SG, 0.79 (0.21) QALYS for TTO for pretreatment facial gender dysphoria, and 0.81 (0.21), 0.86 (0.19), 0.83 (0.20) QALYS for postgender-affirming treatments for facial gender dysphoria. The health utility scores for the postgender-affirming treatments for facial gender dysphoria (+0.06 VAS, p = 0.005) were significantly improved compared with the pretreatment state. Conclusions: To our knowledge, this study is the first to examine how the general population perceives the health burden of facial gender dysphoria experienced by transfeminine patients. Facial gender dysphoria is perceived to have a negative impact on health states, not dissimilar to monocular blindness in our sample. Feminizing facial gender surgery appears to significantly increase health utility measures.


Assuntos
Face/anatomia & histologia , Face/cirurgia , Feminização , Disforia de Gênero/psicologia , Opinião Pública , Adulto , Feminino , Identidade de Gênero , Humanos , Masculino , Anos de Vida Ajustados por Qualidade de Vida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...