Nasal Airway Evaluation.

The nose has several important functions including inspiration, humidification of air, and filtering of allergens. The nose also has a major role in facial harmony as the central focal point. Patients will present to the rhinoplasty surgeon in an effort to fix the inability to breathe through the nose or correct a perceived nasal deformity in the shape of the nose.

Considerations for Optimal Grafting in Rhinoplasty.

A wide variety of grafting materials and techniques can be used to create functional and aesthetic changes in rhinoplasty. Choosing the optimal grafting approach is critical to achieving an optimal patient outcome. We present a review of autografts, allografts, and alloplasts used in primary and revision rhinoplasty and discuss factors that impact graft choice.

Variations in Payer-Negotiated Prices for Head and Neck Reconstructive Surgery.

Objective: Little is known about pricing for reconstructive procedures of the head and neck. As of January 2021, the Centers for Medicare and Medicaid Services requires hospitals to disclose payer-negotiated prices for services, offering new insight into prices for privately insured patients.

Study Design: Cross-sectional analysis.

Patient-Reported Outcomes Measures in Rhinoplasty: Need for Use and Implementation.

Patient-reported outcome metrics (PROMs) are increasingly utilized to capture data about patients' quality of life. PROMs play an important role in the value-based health care movement by providing a patient-centered metric of quality. There are many barriers to the implementation of PROMs, and widespread adoption requires buy-in from numerous stakeholders including patients, clinicians, institutions, and payers.

Disparities in Index of Care for Otolaryngologic Procedures Performed in Ambulatory and Inpatient Settings.

Objective: To compare the same surgical procedure performed in ambulatory and inpatient settings to determine the demographics associated with this selection, the differences in 30-day revisit rates, and the total 30-day cost of care.

Study Design: Retrospective cohort analysis.

Setting: Ambulatory and inpatient centers in Florida, New York, and Maryland.

The Impact of Component Dorsal Hump Reduction on Patient-Perceived Nasal Aesthetics and Obstruction in Rhinoplasty.

Objective: This study aimed to evaluate functional and aesthetic patient-reported outcomes using validated metrics after component dorsal hump reduction (DHR) with spreader graft placement, which have not been previously reported.

Study Design: Prospective cohort study.

Methods: This prospective cohort study was conducted in a tertiary care medical center.

Moving Toward Professional Equity in Otolaryngology.

Gender-based equity in compensation, access to opportunity and resources, and leadership roles are critical to the health and future of otolaryngology; however, significant gaps continue to persist. Professional equity in otolaryngology will be achieved by leadership prioritization of equity as mission critical, improving organizational culture and developing systems for advocacy, understanding what constitutes equal pay in otolaryngology, the development of transparent and reoccurring equity review processes and the promotion of women and underrepresented minorities into leadership positions.

The Impact of Upper Lateral Cartilage Release on Patient-Perceived Nasal Appearance and Obstruction.

Objectives/hypothesis: Although upper lateral cartilages are commonly released from the dorsum of the septum during spreader graft placement in septorhinoplasty (SRP), there has been a focus on maintaining integrity of connections in the middle vault. Avoiding release of upper lateral cartilages in certain patient groups may represent an early step in this paradigm shift. We aim to assess satisfaction with nasal appearance and correction of nasal obstruction in patients who underwent SRP with spreader graft placement without upper lateral cartilage release and compared it to the traditional upper lateral cartilage release cohort.

Computational Fluid Dynamics Modeling of Nasal Obstruction and Associations with Patient-Reported Outcomes.

Background: Nasal obstruction is a common problem, with significant impact on quality of life. Accurate diagnosis may be challenging because of the complex and dynamic nature of the involved anatomy. Computational fluid dynamics modeling has the ability to identify specific anatomical defects, allowing for a targeted surgical approach.

Comparative Effectiveness of Cartilage Grafts in Functional Rhinoplasty for Nasal Sidewall Collapse.

To compare the patient-reported outcomes among patients with nasal obstruction undergoing two rhinoplasty techniques to a control group. Prospective longitudinal study in a university-based tertiary care medical center. All patients undergoing functional septorhinoplasty for correction of lateral wall insufficiency between October 2015 and March 2019 were included;  = 704, mean age (standard deviation) 39.

Otolaryngologists Trail Other Specialties in Industry Payments From Dermal Filler Companies.

Objectives/hypothesis: Dermal filler (DF) is a widely used nonsurgical option for facial rejuvenation with a rapidly expanding market. Physician payments by DF industry leaders have yet to be characterized. We sought to investigate trends in physician-industry payments by DF companies over 6 years.

Patient-Perceived Nasal Appearance After Septorhinoplasty With Spreader Versus Extended Spreader Graft.

Objectives/hypothesis: Standard spreader grafts (SSGs) are commonly used in septorhinoplasty to treat internal nasal valve narrowing and have been shown to improve nasal airway obstruction. Extended spreader grafts (ESGs) have also been proven effective for correcting nasal deviation. To date, the effectiveness of ESGs using patient-reported outcome measures has not been demonstrated, and results of ESGs have not been compared to SSGs.

Unilateral Nasal Obstruction Causes Symptom Severity Scores Similar to Bilateral Nasal Obstruction.

The objective of this paper is to investigate the differences between unilateral and bilateral nasal obstruction with subjective symptomatology in nasal obstruction. This is a retrospective chart review of prospectively collected data of patients with nasal obstruction presenting to a facial plastic and reconstructive surgery clinic for evaluation and treatment. Patient demographics including age and gender were recorded along with nasal physical exam findings.

The Impact of Nasal Obstruction and Functional Septorhinoplasty on Sleep Quality.

Functional septorhinoplasty (FSRP) has been shown to improve both global and disease-specific quality of life (QOL). However, the mechanism by which FSRP improves QOL has not been fully defined. We reasoned that NAO may impact sleep quality and, therefore, studied the relationship using validated patient-reported outcome measures.

Improvement in Snoring-Related Quality-of-Life Outcomes After Functional Nasal Surgery.

Sleep-disordered breathing (SDB) represents a spectrum of sleep-related disorders associated with significant medical comorbidities. Nasal airway surgery has been shown to improve SDB but no large-scale studies exist that describe the long-term impact of surgery on patient perception of snoring and nasal obstruction. To characterize longitudinal snoring symptoms and nasal obstruction after functional nasal surgery for patients with SDB, stratified by history of snoring or obstructive sleep apnea (OSA).

Defining Typical Acetaminophen and Narcotic Usage in the Postoperative Rhinoplasty Patient.

Objective: To characterize the acetaminophen and narcotic use pattern of the postoperative rhinoplasty patient. To describe a pain level and pain medication usage pattern of the typical post-rhinoplasty patient and identify demographic considerations.

Study Design: Prospective cohort study at a tertiary care center.

A Comparative Health Utility Value Analysis of Outcomes for Patients Following Septorhinoplasty With Previous Nasal Surgery.

Importance: Using health utility values (HUVs) as an outcome measure for surgical procedures, including rhinoplasty, allows for a standardized measurement of the qualitative and financial benefit of that procedure on overall health.

Objective: To use Euroqol 5-Dimension (EQ-5D)-derived HUVs to evaluate nasal obstruction outcomes following surgery between primary rhinoplasty (PSRP) and rhinoplasty with previous nasal surgery (RNS) in a prospective cohort study.

Design, Setting, And Participants: A single-institution prospective cohort study between 2013 and 2017 was carried out including 185 patients who underwent RNS before functional rhinoplasty and 278 patients who underwent PSRP for nasal obstruction.

Health Utility Values as an Outcome Measure in Patients Undergoing Functional Septorhinoplasty.

Importance: By measuring health utility values (HUVs) for patients with nasal obstruction after septorhinoplasty, the association of nasal congestion with overall health can be measured and the functional outcomes of septorhinoplasty can be determined.

Objective: To use the EuroQol 5-Dimension (EQ-5D) questionnaire to evaluate nasal obstruction outcomes after septorhinoplasty and to determine HUVs.

Design, Setting, And Participants: This prospective cohort study included patients who underwent septorhinoplasty for nasal obstruction at a single institution by a single surgeon from January 1, 2013, through December 31, 2017.

Preoperative characteristics of over 1,300 functional septorhinoplasty patients.

Objective: To identify characteristics of patients presenting preoperatively for functional septorhinoplasty associated with increased Nasal Obstruction Symptom Evaluation (NOSE) scores.

Study Design: Retrospective analysis of a prospective cohort at a tertiary medical center. Only baseline assessments were analyzed in this cross-sectional study.

Analysis of Patient-Perceived Nasal Appearance Evaluations Following Functional Septorhinoplasty With Spreader Graft Placement.

Importance: Spreader grafts have been shown to improve nasal airway obstruction in patients with nasal valve dysfunction; however, their use has been limited by concerns over their aesthetic penalty of widening the nasal dorsum.

Objective: To evaluate the association of functional septorhinoplasty (FSRP) using spreader graft placement with patient satisfaction with nasal appearance postoperatively.

Design, Setting, And Participants: This prospective cohort study was conducted in a university-based tertiary care medical center.

Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery.

Objectives: To evaluate the long-term impact of functional septorhinoplasty (SRP) with and without inferior turbinate reduction (ITR) on disease-specific symptom severity and general health-related quality of life (QOL).

Study Design: Prospective cohort study at a tertiary referral center.

Methods: Patients undergoing functional SRP with and without ITR were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale to assess severity of nasal obstruction and the EuroQol-5 Dimension Questionnaire Visual Analog Scale (EQ-5D VAS) to assess general health-related QOL preoperatively and at 2, 4, 6, 12, 24, and 36 months postoperatively.