A. F. Doval1, A. Ourian1, V. Chegireddy1, M. Lypka2, J. Friedman1, A. Echo1 1Houston Methodist Hospital,Plastic And Reconstructive Surgery,Houston, TEXAS, USA 2Children’s Mercy Hospital- University Of Missouri Kansas City,Plastic And Reconstructive Surgery,Kansas City, MO, USA
Introduction: Rhinoplasty in children has raised concerns about its impact in nasoseptal growth as well as its safeness in the pediatric population. There is scarcity of evidence describing outcomes and surgical techniques performed in pediatric rhinoplasty. Here, we analyze post-operative complications and cartilage preferences between plastic surgeons and otolaryngologists on a national level.
Methods: Data was collected through the Pediatric National Surgical Improvement Program (NSQIP) from 2012 to 2016. Current Procedure Terminology (CPT) and International Classification of Disease 9th Revision (ICD-9) codes were used for data extraction. A comparison between plastic surgeons and otolaryngologists was made in terms of 30-day post-operative complications followed by a sub-group analysis based on cartilage preferences for rhinoplasty in each specialty.
Results: The data demonstrated that plastic surgeons performed 944 (71.3%) and otolaryngologists performed 380 (28.7%) of rhinoplasty cases. There were significant differences in terms of demographic characteristics between the two specialties including ages, race, ethnicity, and history of congenital malformations (all p < 0.0001). The most common post-operative complications were superficial wound infections (0.3% and 0.8%) and related reoperations for infection drainage and surgical control of hemorrhage (0.6% and 0.3%). No outcome differences between plastic surgeons and otolaryngologists were noted. Subgroup analysis revealed that plastic surgeons prefer to use rib and ear cartilage, while otolaryngologists prefer septal cartilage.
Conclusion: This national level study confirms that rhinoplasty in the pediatric population is a safe procedure. Plastic surgeons and otolaryngologists have comparable 30-day complication rates but the preferences of cartilage usage varies between specialties.