Data Established on Patient-Reported Improvements in Nasal Function Following Component Dorsal Hump Reduction with Spreader Graft

by Linda Kossoff •

Applying validated metrics, what are the functional and aesthetic outcomes reported by patients after receiving cosmetic component dorsal hump reduction (DHR) with spreader graft replacement?

BOTTOM LINE

Cosmetic component DHR with use of spreader grafts to reconstruct the middle vault results in improved subjective nasal function and nasal aesthetics.

BACKGROUND: There is an association of ideal nasal profile and manipulation of the dorsum with social perception in patients who have undergone cosmetic septorhinoplasty (SRP). Component DHR, involving separation/resuspension of the upper lateral cartilages from the septum, addresses this problem, but there is renewed interest in previous techniques that preserve the dorsum.

STUDY DESIGN: Prospective cohort study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Mass.

SYNOPSIS: Researchers identified 226 patients undergoing SRP with spreader graft placement at a single institution between June 2012 and March 2021. Of these, 50% received cosmetic DHR and 50% did not. The non-DHR cohort was the control group. All patients were administered the Nasal Obstruction Symptom Evaluation (NOSE) and the FACE-Q Satisfaction with Nose, Nostrils, and Social Functioning scales preoperatively and at two, four, six, and/or 12 months postoperatively. Both cohorts had similar statistically and clinically significant improvements in NOSE and FACE-Q scores. Postoperative FACE-Q scores were higher in the cosmetic DHR cohort, despite lower preoperative FACE-Q scores compared to the control cohort. Mean change in FACE-Q scores was significantly higher in the cosmetic DHR cohort. Authors say this study provides patient-reported outcome data associated with open SRP, cosmetic component DHR with spreader graft reconstruction, and that baseline outcome data can now be compared with that of other techniques used to manage the dorsal hump. Study limitations include the fact that it is a single surgeon experience with the inclusion of unmatched, primary, and revision rhinoplasty patients.

CITATION: Burks CA, Weitzman RE, Lindsay RW. The impact of component dorsal hump reduction on patient-perceived nasal aesthetics and obstruction in rhinoplasty. Laryngoscope. 2022;132:2157-2161.