Basic Open Rhinoplasty Guidelines

Updated: Apr 15, 2019
  • Author: Jugpal S Arneja, MD, MBA, FRCSC; Chief Editor: Mark S Granick, MD, FACS  more...
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Guidelines

Guidelines Summary

American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNS)

In 2017, the AAO-HNS released the following clinical practice rhinoplasty guidelines [16] :

  • Clinicians should query patients about their motivations for seeking rhinoplasty and their expectations regarding the surgery’s outcome; the clinician should also counsel patients as to whether their expectations are realistic and should make sure that there is a medical record of the discussion
  • Patients seeking rhinoplasty should be evaluated for comorbidities that could result in the surgery being modified or contraindicated, including obstructive sleep apnea (OSA), body dysmorphic disorder (BDD), bleeding disorders, and chronic topical vasoconstrictive intranasal drug use
  • Preoperative assessment should include evaluation of the patient for nasal airway obstruction, as conducted by the surgeon or his/her designee
  • Patients should be advised by the surgeon or his/her designee about rhinoplasty’s potential impact on nasal breathing, possible surgical complications, and the chance that future nasal surgery will be required
  • Patients with documented OSA should be advised by the clinician or his/her designee with regard to rhinoplasty’s effect on nasal airway obstruction and possible OSA-related considerations in perioperative management
  • Patients should receive information from the surgeon or his/her designee about the management of postoperative discomfort
  • Antibiotic therapy, when administered perioperatively by the surgeon or his/her designee, should not routinely last more than 24 hours postsurgery
  • Perioperative systemic steroids may be administered, by the surgeon or his/her designee, to rhinoplasty patients
  • The guidelines recommend against routine nasal packing at the conclusion of surgery, whether or not the rhinoplasty patient has undergone septoplasty