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Dorsal Preservation Versus Component Dorsal Hump Reduction Rhinoplasty: A Systematic Review And Meta-analysis Of Patient-reported Outcomes
Ngamthoiba Joy, MBBS
1,
Jose A. Foppiani, MD2, Angelica Hernandez Alvarez, MD
2, Maria J. Escobar-Domingo, MD
2, Daniela Lee, BS
2, Iulianna C. Taritsa, BA
2, Kirsten A. Schuster, MD, JD
2, Nancy M. Aneken, MD
3, Bernard T. Lee, MD, MBA, MPH
2, Samuel J. Lin, MD, MBA
2;
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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