Short Nose Rhinoplasty Workup

Updated: Nov 05, 2018
  • Author: Joseph L Leach, Jr, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Laboratory Studies

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  • Obtain benzoylecgonine levels for patients in whom cocaine abuse is suspected to exclude recent cocaine use. Such patients should have abstained from cocaine use for more than a year.

  • A complete blood count, serologic tests for syphilis, a tuberculin skin test, rheumatoid factor, and an erythrocyte sedimentation rate are helpful in determining infectious or autoimmune etiologies.

  • Aerobic, anaerobic, and acid-fast cultures of nasal secretions may be indicated.

  • An antineutrophil cytoplasmic antibody test, if positive, is highly specific for Wegener granulomatosis.

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Imaging Studies

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  • Preoperative photographs should be taken from at least 4 different views. Most surgeons prefer 6 standard views, including frontal, right and left laterals, right and left obliques, and basal views.

  • Although not mandatory, preoperative radiography or CT scanning may indicate the extent of bone or cartilage loss.

  • Chest radiography is helpful in determining infectious or autoimmune etiologies.

  • Although plain radiographic studies and CT scanning often are performed around the time of trauma to the nose and mid face, these studies are not essential for reconstruction of the short nose. Using a careful physical examination to determine the amount of bony and cartilaginous deficiency is more reliable.

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Other Tests

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  • Acoustic rhinometry is often used to verify subjective descriptions of nasal obstruction.

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Diagnostic Procedures

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  • A tissue biopsy may be necessary to confirm the presence of neoplastic or autoimmune disease. Biopsies for this indication are notoriously unreliable, however. Biopsy is probably best performed when cancer is strongly suspected.

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