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Objective Assessment of Tip Projection and the Nasolabial Angle in Rhinoplasty
Susanne Spörri;
Daniel Simmen, MD;
Hans Rudolf Briner, MD;
Nick Jones, MD, FRCS
Arch Facial Plast Surg. 2004;6:295-298.
Objective To provide an objective method to measure the extent of nasal tip projection and the nasolabial angle.
Design We retrospectively studied preoperative and postoperative images using a novel approach. The constant position of the cornea in lateral views and the diameter of the iris in frontal views were used to standardize and compare digitalized images of patients before and after surgery. We tested this objective assessment technique using the digitized slides of patients with saddle nose deformities and measured changes in their nasal tip projection and nasolabial angle. We included 63 patients who had undergone an open rhinoplasty with the I-beam technique by the same surgeon over a 7-year period. We tested the reproducibility of these measurements with 10 independent investigators. We also determined whether the measurements using this objective technique correlated with the surgeon's or patients' subjective assessments of the outcome.
Results We were able to use the objective measurement technique in 42 patients (67%). It was not possible to use the technique in 21 patients (33%) because the photographic conditions had not been fulfilled. The measurement variability of 10 different investigators expressed as standard deviations in percentage of the mean value was 6.7% for nasal tip projection and 1.3% for the nasolabial angle. The surgeon's subjective assessment of the outcome correlated with the objective changes of nasal tip projection (P = .045) and the nasolabial angle (P = .045). There was no correlation between the patients' assessments and the objective measurements.
Conclusions The objective measurements tested were easy to use and investigator independent. They also correlated with the surgeon's assessment of outcome.
From the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital (Ms Spörri), and the Center for Otology, Skull Base Surgery, Rhinology, and Facial Plastic Surgery, Klinik Hirslanden (Drs Simmen and Briner), Zurich, Switzerland; and the Department of Otorhinolaryngology, University of Nottingham, Nottingham, England (Dr Jones).
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