Consensus in rhinoplasty
J.J. Daele*, E. Leruth**, Y. Goffart*
* ENT-HNS Department, CHR Citadelle, Li├Ęge; ** ENT-HNS Department, UCL Mont-Godinne, Yvoir
Rhinoplasty; surgical survey; surgical techniques
109 - 113
Reading textbooks or manuals about rhinoplasty techniques, the novice may be disconcerted by the multi- tude of different surgical manoeuvres, all intended to achieve the same result: a cosmetically appealing and functional nose. This article describes a survey of 30 rhinoplasticians that investigated, using a questionnaire with 51 items, cur- rent opinion and practice in rhinoplasty with the aim of identifying areas of consensus or disagreement. Only 16 ques- tions in 51 (31%) identified a strong consensus, mainly in the areas of informed consent, lateral osteotomies, and the accuracy and predictability of some graft procedures (columellar strut, spreader graft). There was also a consensus about the rejection of some unusual procedures (electric-powered rasping of the dorsum, allopathic implants). However, no consensus was found in many domains, such as tip or columella management, resection of the dome, dome sutures, alar batten grafts, dorsal graft, nasal packing, pre-operative functional investigations, morphing, alar base reduction or the management of septal perforation. Our survey found a dramatic lack of agreement about rhinoplastic procedures, which remain highly dependent on the skill and experience of surgeons who favour the techniques with which they have achieved good results in the past. It also identifies a case for adopting, as in other fields of me6-8ine, guidelines based upon consensual expert opinion and the evaluation of outcomes with appropriate and validated instruments.
Suppl. 15, 2010

Consensus in rhinoplasty