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Rhinoplasty

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2 Key Points Î Rhinoplasty ranks among the most commonly performed cosmetic procedures in the United States, with over 200,000 procedures reported in 2014. Î The primary reason for surgery can be aesthetic, functional, or both, and may include adjunctive procedures on the nasal septum, nasal valve, nasal turbinates, or the paranasal sinuses. Î The average uncomplicated rhinoplasty procedure typically exceeds $4,000. However, the costs incurred due to complications, infections, or revision surgery (long-term antibiotics, hospitalization, and lost revenue from hours/days of missed work) add considerably to the total. Î The resultant psychological impact of rhinoplasty can also be significant. Table 1. Definitions of Words Used in the Guideline Rhinoplasty Rhinoplasty is a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway. e primary reason for surgery can be aesthetic, functional, or both, and may include adjunctive procedures on the septum, turbinates, or paranasal sinuses. (When these adjunctive procedures, however, are performed without an impact on nasal shape or appearance, they do not meet the definition of rhinoplasty used in this guideline). Aesthetic Concerned with beauty or the appreciation of beauty. Body Dysmorphic Disorder Psychiatric disorder consisting of distressing or impairing preoccupation with nonexistent or slight defects in one's appearance. Cosmetic Relating to treatment intended to restore or improve appearance. Rhinitis Inflammation of the mucus membranes of the nose frequently caused by infection or allergic reaction. It typically manifests with symptoms of nasal itching, increased mucus drainage, congestion, or post nasal drainage. Obstructive Sleep Apnea Sleep disorder involving at least five obstructive respiratory events per hour (detected during an overnight sleep study). Nasal cycle e oen unnoticed alternating partial congestion and decongestion of the nasal cavities in humans and other animals. It is a physiological congestion of the nasal turbinates due to selective activation of the autonomic nervous system on one side of the nose. Anterior rhinoscopy Examination of the anterior part of the nose, including the inferior turbinate, the septum, and the nasal valves. Nasal packing Nasal packing is material, either removable or absorbable, placed inside the nose to promote hemostasis, structural support, and reduction of scar formation. Traditional nasal packs include ribbon gauze, expandable non- biodegradable pads, and non-stick dressing material. (Yan M, Zheng D, Li Y, et al. Biodegradable nasal packings for endoscopic sinonasal surgery: a systematic review and meta-analysis. PLos One. 2014; 9(12): e115458.) ere are many newer types of packing that are biodegradable. Silastic stents or nasal splints, and custom cut sheeting are not considered packing.

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