The Effect of Postrhinoplasty Taping on Postoperative Edema and Nasal Draping
Condition: Nasal Deformity; Edema; Rhinoplasty
MeSH terms: Edema
Study type: Interventional

Summary: 
      The purpose of this study was to investigate the effectiveness of postrhinoplasty taping. The
      effectiveness was evaluated with Ultrasonography and skin envelope thickness was
      prospectively measured for analysis.
    

Detailed description: 
      All patients were informed individually about the procedures and written informed consent was
      obtained before the study. Undergoing primary open approach reduction rhinoplasty and
      receiving osteotomies with lateral guarded osteotomes was an inclusion criteria for the
      study. Fifty-seven consecutive primary open approach rhinoplasty patients that referred to
      our tertiary reference center were enrolled in the study. Patients were appointed to either
      the control, 2-week PRT or 4-week PRT group in a randomized-consecutive fashion. External
      thermoplastic splint was removed at the end of first postoperative week. Patients in the
      control group were not subjected to further nasal taping after cast removal. All patients in
      2-week (from first to third week) and 4-week (from first to fifth week) PRT groups received
      taping during their allocated time in addition to one week with external nasal splint. These
      two groups were provided with 1/2-inch wide tan-colored hypoallergenic 3M™ Micropore™
      Surgical Tapes (3M, St Paul, Minnesota). Each volunteer was individually shown how and given
      instructions regarding PRT.

      Nasal swelling of the patients were evaluated individually with a 7.5 mHz linear ultrasound
      (US) probe: small amount of ultrasonic gel was used to scan the skin in a noncontact mode to
      prevent distortion of nasal anatomy from transducer pressure. The examiner did not have
      access to the results of the previously obtained measurements in order to prevent
      measurements from being contaminated. Measurements were carried out on four different points:
      nasion, rhinion, supratip and tip and from these four measurements, mean nasal skin thickness
      (MNST) was calculated.

      Subjects in each group were sorted, based on the baseline MNST measurement, consecutively
      from lowest to highest; half of the patients with higher MNST measurements were categorized
      as 'thick skinned' and the other half was categorized as 'thin skinned'. The electronic
      caliper of the machine measured the perpendicular distance from the outer epidermal surface
      to the underlying cartilage on the 2-dimensional B-mode image (Capasee II Ultrasound, Toshiba
      Medical Systems, Tustin, California). US measurements were carried out five times for each
      individual subject: preoperatively; at the end of first, third and fifth postoperative weeks;
      and sixth postoperative month. Measurements were carried out mainly in the morning to avoid
      the effect of diurnal variation on the dermal edema.

      Surgical Technique All of the patients were operated with open approach rhinoplasty under
      general anesthesia. All patients underwent rhinoplasty due to cosmetic and functional
      purposes. All cases were distributed evenly between the surgeons (BO, YSY, BV, ST).
      Supraperichondrial and subperiosteal dissection plane was the preferred plane of dissection
      in all the cases. Surgical operation was mainly reduction rhinoplasty and comprised of dorsal
      reduction and bilateral lateral osteotomies. All lateral osteotomies were carried out
      intranasally with guarded curved lateral osteotomes. Incision-to-closure operative duration
      was recorded for each patient. All subjects were routinely administered 0.1mg/kg
      dexamethasone during the operation. All cases were applied with internal splints, taped with
      3M micropores and casted with external thermoplastic splints at the end of the operation.
      Postoperative suggestions, orders and medications were identical for all groups. Patients
      were discharged from the hospital on first postoperative day. All subjects were called back
      on the end of first postoperative week for removal of external nasal packing.

      Statistical Analysis Statistical data were analysed using SPSS 20.0 (SPSS, Chicago,IL). All
      values were calculated and stated in descriptive statistics as mean±Standard deviation unless
      otherwise stated. ANOVA was used for comparison of means. Repeated ANOVA was used for each
      patient where the repeated factor was the ultrasonographic measurements (preoperative, first
      postoperative week, third postoperative week, fifth postoperative week and sixth
      postoperative month). Significant results of repeated ANOVA test were further analysed via
      pairwise comparison with Bonferroni correction. Correlation analysis was carried out with
      Pearson correlation analysis. Values of p<0.05 were considered statistically significant.
    

Intervention name(s): Postrhinoplasty taping
Intervention type(s): Procedure
Intervention description(s): Postrhinoplasty taping is commonly applied by rhinoplasty surgeons. Following rhinoplasty the nose is generally taped and a (thermoplastic) nasal cast is applied on top of this to make sure the final form of the nose is protected. Postoperatively, this cast is removed at some point. After this, some of the surgeons prefer to tape the nose with nasal tapes such as Micropore (3M) etc. Postrhinoplasty taping is the term used for this. The nose is (generally) taped horizontally with 1/2 inch wide tapes. This is done superiorly from radix to inferiorly to nasal tip. The idea is to compress the nose and to cover it. The duration of postrhinoplasty taping differs according to the preference of the surgeon and the patient
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: rhinoplasty; postrhinoplasty taping; edema; draping; postoperative edema; nasal skin thickness; supratip fullness; postoperative swelling