The first evidence-based guideline for rhinoplasty has been developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation and published in the journal Otolaryngology-Head and Neck Surgery.

The recommendations, which focus on improving patient care, include communicating expectations, comorbid conditions, nasal airway obstruction, preoperative education, patient counseling for obstructive sleep apnea, managing pain and discomfort and outcomes assessment.

Lisa Ishii, M.D., MHS, chair of the guideline group, tells Cosmetic Surgery Times that “clinicians can refer to the guideline when making decisions about pre- and postoperative management, such as information to collect from the patient before the procedure, and medications to administer after the procedure. Hopefully the guideline will ultimately lead to optimal patient outcomes and decrease unintentional variation in care.”

Dr. Ishii, an associate professor and director of research in facial plastic and reconstructive surgery in the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins School of Medicine, says the two most notable recommendations relate to antibiotics and packing.

“The evidence does not support routinely providing postoperative antibiotics for patients undergoing rhinoplasty, a practice currently common to many surgeons,” she notes. “The guideline also does not support routine placement of nasal packing.”

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