부비동 내시경수술과 코성형술의 동시 시행의 효용성과 한계
Combined Endoscopic Sinus Surgery and Rhinoplasty: Efficacy and Limitation
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Background and Objectives Combined endoscopic sinus surgery (ESS) and rhinoplasty may benefit patients but can pose a considerable task to the surgeon at the same time. The aim of this study is to analyze the surgical outcomes of the concurrent ESS and rhinoplasty with emphasis on the efficacy and limitation. Subjects and Method Consecutive 21 patients who underwent concurrent ESS and rhinoplasty (combined group) were identified. For comparison, rhinoplasty group who had only rhinoplasty and ESS group who had only ESS over the same period were selected. Medical records, endoscopic findings, and CT scans were reviewed. A telephone survey was done to evaluate subjective outcomes of the surgery. Objective aesthetic outcomes of rhinoplasty were evaluated by comparing the preoperative and postoperative photos by two rhinoplasty surgeons. Results In the combined group, ten patients (24%) had ESS-related complications and one patient (5%) had rhinoplasty-associated complications. On the other hand, only one patient (5%) had recurred rhinosinusitis in the ESS group but three patients (14%) had complications including revision surgery in rhinoplasty group. Subjective functional satisfaction score after ESS and subjective aesthetic satisfaction score after rhinoplasty did not show any significant difference between the combined group and each matching group. Objective aesthetic evaluation did not show any difference either. Conclusion Concurrent ESS and rhinoplasty have similar subjective functional improvement and objective surgical outcome compared with ESS alone or rhinoplasty alone. However, concurrent surgery had a tendency to show poorer surgical outcome in ESS than in rhinoplasty warranting a cautious approach with patient selection. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(7):460-5
Abstract
Background and Objectives Combined endoscopic sinus surgery (ESS) and rhinoplasty may benefit patients but can pose a considerable task to the surgeon at the same time. The aim of this study is to analyze the surgical outcomes of the concurrent ESS and rhinoplasty with emphasis on the efficacy and limitation. Subjects and Method Consecutive 21 patients who underwent concurrent ESS and rhinoplasty (combined group) were identified. For comparison, rhinoplasty group who had only rhinoplasty and ESS group who had only ESS over the same period were selected. Medical records, endoscopic findings, and CT scans were reviewed. A telephone survey was done to evaluate subjective outcomes of the surgery. Objective aesthetic outcomes of rhinoplasty were evaluated by comparing the preoperative and postoperative photos by two rhinoplasty surgeons. Results In the combined group, ten patients (24%) had ESS-related complications and one patient (5%) had rhinoplasty-associated complications. On the other hand, only one patient (5%) had recurred rhinosinusitis in the ESS group but three patients (14%) had complications including revision surgery in rhinoplasty group. Subjective functional satisfaction score after ESS and subjective aesthetic satisfaction score after rhinoplasty did not show any significant difference between the combined group and each matching group. Objective aesthetic evaluation did not show any difference either. Conclusion Concurrent ESS and rhinoplasty have similar subjective functional improvement and objective surgical outcome compared with ESS alone or rhinoplasty alone. However, concurrent surgery had a tendency to show poorer surgical outcome in ESS than in rhinoplasty warranting a cautious approach with patient selection. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(7):460-5
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