Pediatric rhinoplasty: A discussion of perioperative considerations and systematic review

Amar Gupta, Peter F. Svider, Hani Rayess, Anthony Sheyn, Adam J. Folbe, Jean Anderson Eloy, Giancarlo Zuliani, Michael A. Carron

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objectives Pediatric rhinoplasty has traditionally raised numerous concerns, including its impact on growth as well as the psychological sequelae of undergoing a potentially appearance-altering procedure. Our objective was to critically evaluate available individual patient data relevant to pediatric rhinoplasty, and further discuss perioperative considerations. Methods A systematic review was conducted using PubMed/MEDLINE databases. Data extracted and analyzed from included studies included patient demographics, surgical indications, operative approaches, outcomes, complications, revision rates, and other clinical considerations. Results Seven studies encompassing 253 patients were included, with age ranging from 7 months to 19 years. Two-thirds of patients were male. 41.7% reported antecedent trauma, and common overall surgical indications included “functional aesthetic” (24.5%) followed by cleft lip nasal deformity (15.8%). The majority (79.1%) underwent open approaches, and 71.1% of patients underwent concomitant septal intervention. The most frequently used grafting materials were septal cartilage (52.8%) and conchal cartilage (16.5%). Surgical outcomes were heterogeneous among these studies. Complication rates were only specified in 5 of the 7 studies and totaled 57 patients (39.6%). Aesthetic dissatisfaction (11.8%) and postoperative nasal obstruction (5.6%) were the most commonly reported complications. Revisions were performed in 13.5%. Conclusion Rhinoplasty is safe in the pediatric population, although revisions rates appear greater than those reported in adults. This study of 253 represents the largest pooled sample size to date; nonetheless, non-standardized outcome measures, minimal long-term followup data, and lack of discussion regarding psychological sequelae all contribute to the need for further high-quality studies evaluating this topic.

Original languageEnglish (US)
Pages (from-to)11-16
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume92
DOIs
StatePublished - Jan 1 2017

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

Keywords

  • Adolescent rhinoplasty
  • Pediatric rhinoplasty
  • Rhinoplasty in children
  • Systematic review

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