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The effect of preservation rhinoplasty on nasal function (Master thesis)

Καστανιουδάκη, Πολυνίκη/ Kastanioudaki, Polyniki/ Ρινολογία - ρινοχειρουργική

Background and Objective: In Joseph’s classic open structural rhinoplasty and conventional dorsal hump reduction techniques, hump resection and subsequent middle-vault reconstruction disrupt the anatomical integrity of the nasal dorsum, potentially resulting in iatrogenic deformities and consequent functional impairment. Preservation rhinoplasty (PR) is an alternative surgical approach aimed at reshaping the nose while preserving native anatomical structures and maintaining the integrity of the keystone area and stability of the middle vault. This systematic review aimed to evaluate the effects of PR techniques on nasal function. Materials and Methods: The study was designed and reported in accordance with the PRISMA guidelines and the PICO framework. A systematic search was conducted in PubMed/MEDLINE and Embase. Primary clinical studies of adults evaluating nasal function following PR using objective methods and/or patient-reported outcome measures (PROMs) were included. Results: Of 481 records identified, 31 studies involving 2,526 patients and follow-up periods ranging from 6 to 37 months were included. PROMs, including NOSE, SCHNOS, SNOT-22, VAS, ROE, and RHINO, consistently demonstrated postoperative improvement. Objective assessments included acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow, and imaging-based measurements of the internal nasal valve. Overall, preservation or increases in minimum cross-sectional area and nasal cavity volume, improved airway geometry, increased nasal airflow, and reduced nasal resistance were observed. Most comparative studies reported no statistically significant differences between PR and conventional techniques in overall functional outcomes. Conclusions: Overall, the available evidence suggests that PR is associated with the preservation or improvement of postoperative nasal function, with functional outcomes comparable to those of conventional techniques. Therefore, PR seems to represent a safe and effective alternative surgical approach in appropriately selected patients.