Our Summary
This research paper examines the combined performance of two types of nose surgeries: rhinoplasty (nose reshaping or “nose job”) and functional endoscopic sinus surgery (FESS, a procedure to treat sinusitis and other related issues).
Using surgery data from California, Florida, Maryland, and New York from 2009 to 2011, the researchers compared various aspects such as patient demographics, surgeon volume, cost, associated nasal procedures, and operating room time, for standalone rhinoplasty, standalone FESS, and combined rhinoplasty and FESS.
The study found that in the combined rhinoplasty and FESS cases, most involved primary rhinoplasty (first time nose reshaping), with fewer involving nasal valve repair or revision rhinoplasty (corrective nose reshaping). Interestingly, the number of combined surgeries performed was similar across high-volume, medium-volume, and low-volume rhinoplasty surgeons.
Most of the combined surgeries involved two or fewer sinuses, and the average operating room time for the combined surgeries was approximately 50 minutes shorter than the total time for the two standalone surgeries performed separately.
The researchers concluded that the combined surgeries may be chosen for cases with less severe sinus disease and less complex rhinoplasty needs, as these cases are less likely to involve revision rhinoplasty compared to standalone rhinoplasty, and involve fewer sinuses compared to standalone FESS. The combined procedures also reduce operating room time compared to performing the two surgeries separately.
FAQs
- What are the two types of nose surgeries examined in this research paper?
- What were the key findings of the study in relation to combined rhinoplasty and FESS cases?
- How does the operating room time for combined surgeries compare to standalone surgeries?
Doctor’s Tip
A helpful tip a doctor might tell a patient about sinus surgery is to carefully follow all post-operative instructions provided by your surgeon, including any medication regimen, wound care, and activity restrictions. This will help ensure a successful recovery and optimal outcome from the surgery. Additionally, it is important to attend all follow-up appointments with your surgeon to monitor your progress and address any concerns or complications that may arise.
Suitable For
Overall, patients who may be recommended for sinus surgery, specifically functional endoscopic sinus surgery (FESS), include those who suffer from chronic sinusitis that does not respond to conservative treatments such as medications and nasal sprays. These patients may experience symptoms such as facial pain, pressure, congestion, and recurrent infections.
In terms of rhinoplasty, patients who are typically recommended for this type of surgery are those seeking cosmetic improvement to the appearance of their nose, such as correcting a bump on the bridge of the nose, refining the tip, or improving the overall shape and symmetry of the nose.
Patients who may benefit from combined rhinoplasty and FESS surgery are those who have both cosmetic concerns with their nose and functional issues related to their sinuses. This could include patients with nasal obstruction due to a deviated septum or enlarged turbinates, as well as underlying sinus disease that may be contributing to their symptoms.
Ultimately, the decision to recommend sinus surgery, whether standalone FESS, rhinoplasty, or a combination of both, will depend on the individual patient’s symptoms, medical history, and goals for surgery. It is important for patients to consult with an ENT (ear, nose, and throat) specialist or a plastic surgeon who specializes in nasal surgery to determine the most appropriate treatment plan for their specific needs.
Timeline
Before sinus surgery:
- Patient experiences symptoms of chronic sinusitis, such as nasal congestion, facial pain, and difficulty breathing.
- Patient undergoes diagnostic tests, such as CT scans or nasal endoscopy, to determine the extent of sinus disease.
- Patient consults with an ENT specialist to discuss treatment options, including medication, nasal sprays, and sinus surgery.
- Patient undergoes pre-operative evaluations, such as blood tests and anesthesia clearance.
- Patient is informed of the risks and benefits of sinus surgery and prepares for the procedure.
After sinus surgery:
- Patient is monitored in the recovery room for a few hours post-surgery.
- Patient may experience mild pain and swelling in the nose and sinuses.
- Patient is given post-operative instructions, including how to care for the nasal packing or splints, and medications for pain and inflammation.
- Patient follows up with the surgeon for post-operative appointments to monitor healing and address any concerns.
- Patient gradually resumes normal activities and may notice improvement in sinus symptoms over time as the sinuses heal and inflammation decreases.
What to Ask Your Doctor
Some questions a patient should ask their doctor about sinus surgery include:
- What specific sinus issues do I have that require surgery?
- What are the benefits of combining rhinoplasty with functional endoscopic sinus surgery in my case?
- What is your experience and expertise in performing both rhinoplasty and FESS procedures?
- What are the potential risks and complications associated with combined sinus surgery?
- How long is the recovery period for combined rhinoplasty and FESS surgery?
- Will I need any additional follow-up procedures or treatments after surgery?
- What is the success rate of combined rhinoplasty and FESS surgery for patients with similar conditions to mine?
- Are there any alternative treatment options for my sinus issues that I should consider before opting for surgery?
- How much will the combined surgery cost, and will my insurance cover any of the expenses?
- What can I expect in terms of post-operative pain management and overall discomfort during the recovery process?
Reference
Authors: Kochhar A, Zhang Y, Fisher L, Byrne P, Smith SS, Ference EH. Journal: Laryngoscope. 2020 May;130(5):E311-E319. doi: 10.1002/lary.28031. Epub 2019 May 11. PMID: 31077393