American Association of Plastic Surgeons

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Dorsal Preservation Versus Component Dorsal Hump Reduction Rhinoplasty: A Systematic Review And Meta-analysis Of Patient-reported Outcomes
Ngamthoiba Joy, MBBS1, Jose A. Foppiani, MD2, Angelica Hernandez Alvarez, MD2, Maria J. Escobar-Domingo, MD2, Daniela Lee, BS2, Iulianna C. Taritsa, BA2, Kirsten A. Schuster, MD, JD2, Nancy M. Aneken, MD3, Bernard T. Lee, MD, MBA, MPH2, Samuel J. Lin, MD, MBA2;
1Jalalabad Ragib Rabeya Medical College & Hospital, Sylhet, Bangladesh, 2Beth Israel Deaconess Medical Center, Boston, MA, USA, 3Centre hospitalier intercommunal Meulan les Mureaux,, Meulan, France

PURPOSE: The literature on patient-reported outcomes (PROs) discussing dorsal preservation rhinoplasty (DPR) and component dorsal hump reduction (CDHR) is scarce. Consequently, this study aims to fill the gap on PROs between these techniques.
METHODS:A systematic review was conducted adhering to PRISMA guidelines to investigate PROs of DPR and CDHR. A proportion meta-analysis was conducted using Stata statistical software.
RESULTS: A total of 19 studies met our inclusion criteria, pooling 1523 participants, with 12 studies on CDHP and 7 studies on DPR. Overall satisfaction rates were substantially high, varying from 84% to 100% across studies. A subgroup analysis revealed that both techniques exhibited equally high satisfaction with no statistical differences (P=0.18). Utilizing a random-effects model, the data suggests about 2 out of 100 treated patients will undergo revisions (95% IQR: 0-4). Furthermore, the CDHR technique was associated with a significant 53.7-point reduction in the SCHNOS-C domain (95% CI: -62.7 to -44.8, P < 0.001), along with a meaningful improvement in SCHNOS-O scores by -27.3 points (95% CI: -50.5 to -4.04, P = 0.02). Conversely, the DPR was linked to a 55.3-point reduction in the SCHNOS-C domain (95% CI: -60.7 to -49.9, P < 0.001), and a -19.5 point change in the SCHNOS-O domain (95% CI: -27.9 to -11.1, P < 0.001). CONCLUSION: While PROs are comparable between both techniques, based on the literature CDHR outcomes may be better than DPR in alleviating subjective respiratory obstructive symptoms, potentially offering a evidence based choice for addressing functional concerns in rhinoplasty.
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