Revision rhinoplasty: physician–patient aesthetic and functional evaluation

Citation data:

Brazilian Journal of Otorhinolaryngology (Versão em Português), ISSN: 2530-0539, Vol: 84, Issue: 6, Page: 736-743

Publication Year:
2018

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DOI:
10.1016/j.bjorlp.2017.10.014
Author(s):
Heloisa Nardi Koerner Vian; Cezar Augusto Sarraff Berger; Danielle Candia Barra; Ana Paula Perin
article description
Approximately 5–15% of patients submitted to rhinoplasty operations undergo revision surgery. Those patients have varied functional and aesthetic complaints that should receive a detailed assessment that includes all the expectations the patient had before the previous procedure. To draw the profile of the main aesthetic‐functional complaints reported by patients to be submitted to revision rhinoplasty and to correlate them with the internal and external objective nasal evaluation performed by the surgeon. A prospective study was conducted with 43 patients to be submitted to revision rhinoplasty and their respective surgeons, by applying a questionnaire about the patients’ epidemiological questions and subjective aesthetic‐functional complaints as well as the respective functional deformities observed by the surgeons. Subsequently, these data were correlated with the purpose of observing the frequency of congruent reports between physicians and patients. The presence of drooping tip and residual bridge hump were the patients’ main complaints, confirmed by the surgeons. The correlation between subjective obstructive symptoms and the intranasal evaluation performed by surgeons was shown to be present in 87.5% of the cases. Among the patients with respiratory symptoms, the main deformity identified was residual septal deviation in 56.25% of the cases. The drooping tip followed by residual hump were the main complaints reported by the patients and confirmed by the objective examination by the physicians. The presence of nasal obstructive complaints in 37.2% of the patients shows that greater attention needs to be paid to functional deformities during the first surgical procedure. The differences observed between patients’ complaints and surgeons’ evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities. As rinoplastias possuem índice de revisão em torno de 5% a 15% dos pacientes operados. Tais pacientes possuem queixas funcionais e estéticas variadas e a avaliação detalhada é de extrema importância, tendo em vista todas as expectativas em torno de um procedimento já anteriormente realizado. Traçar o perfil das principais queixas estético‐funcionais referidas pelo paciente a ser submetido à rinoplastia revisional e correlacioná‐las a avaliação nasal objetiva interna e externa realizada pelo cirurgião. Foi realizado um estudo prospectivo com 43 pacientes a serem submetidos à rinoplastia revisional e com seus respectivos cirurgiões, através da aplicação de questionário acerca de questões epidemiológicas e queixas estético‐funcionais subjetivas dos pacientes e as respectivas deformidades funcionais observadas pelos cirurgiões. Após, esses dados foram correlacionados com a finalidade de observar a frequência de relatos concomitantes entre os médicos e pacientes. A presença de ponta caída e giba óssea residual foram as principais queixas dos pacientes confirmadas pelos cirurgiões. Já a correlação entre sintomas subjetivos obstrutivos e a avaliação intranasal realizada pelos cirurgiões demonstrou estar presente em 87,5% dos casos. Dentre os pacientes com sintomas respiratórios, a principal deformidade encontrada foi o desvio septal residual em 56,25% dos casos. A ponta caída seguida de giba óssea residual foram as principais queixas relatadas pelos pacientes e confirmadas ao exame objetivo pelos médicos. A presença de 37,2% dos pacientes com queixas obstrutivas nasais demonstra que maior atenção deve ser dada a deformidades funcionais já durante o primeiro procedimento cirúrgico. As diferenças observadas entre as queixas dos pacientes e avaliações dos cirurgiões comprovam a necessidade da avaliação pormenorizada e esclarecimento ao paciente com relação as suas expectativas e reais possibilidades cirúrgicas.