Comparison of Patient-Reported Outcomes Between Dorsal Preservation and Conventional Dorsal Hump Reduction Rhinoplasty: A Systematic Review and Meta-Analysis.

Summary

Across six studies (n=753), dorsal preservation rhinoplasty improved early patient-reported cosmetic satisfaction versus conventional hump reduction (significant VAS-C and SCHNOS-C differences), but this advantage disappeared beyond six months. Functional outcomes for nasal obstruction were similar between techniques at one year.

Key Findings

• Dorsal preservation rhinoplasty showed significantly higher early cosmetic satisfaction (VAS-C and SCHNOS-C) than conventional hump reduction.
• No significant differences in nasal obstruction outcomes (VAS-O, SCHNOS-O, NOSE) between techniques at one year.
• Cosmetic superiority of dorsal preservation diminished after six months, with similar outcomes thereafter.

Clinical Implications

Surgeons can counsel patients that dorsal preservation may offer better early cosmetic satisfaction without long-term functional superiority, aligning expectations and follow-up planning.

Limitations

• Only six studies with potential heterogeneity in techniques and follow-up; many underlying studies are non-randomized (Level III).
• Variability in timing and instruments may introduce reporting bias.

Future Directions

Prospective randomized comparisons with standardized outcome timing and longer follow-up to assess durability and functional trade-offs, including revision rates.