title: Treatment outcomes of pediatric rhinoplasty: the Asan Medical Center experience.
abstract: OBJECTIVE
  Performing rhinoplasty in children has been an issue of some debate due to concerns about potential harmful effects on nasoseptal growth. However, there is a paucity of evidence describing the outcomes of pediatric rhinoplasty. This study presents our experience of performing this procedure in children of 17 years of age and younger.
  
  
  METHODS
  The study population consisted of 64 Korean children between 4 and 17 years of age who underwent rhinoplasty between May 2003 and August 2011. Forty-six of the patients were boys and 18 were girls with a mean follow-up period of 59 months. The diagnosis of the patients, the extent of the surgical maneuver performed, and the surgical outcomes were reviewed. Subjective satisfaction of the patients was investigated by telephone interview. Surgical outcomes, which were judged by two independent ENT surgeons, were evaluated by comparing preoperative and postoperative photographs. Satisfaction scores were graded using a visual analog scale (from 1 = satisfied, to 4 = dissatisfied). Anthropometric measurements of nasal parameters were performed preoperatively and postoperatively.
  
  
  RESULTS
  Rhinoplasty was performed in our patient cohort due to a deviated nose (32.8%), nasal bone fracture (18.8%), flat nose (6.3%), nasal mass (4.7%), hump nose (3.1%), nasal dermoid sinus cyst (1.6%), and additional cosmetic rhinoplasty for planned septoplasty (32.8%). The median patient satisfaction score was 2.09 compared with a median doctor satisfaction score of 1.81. Anthropometric measurements showed statistically significant improvements in nasal tip projection, nasal length, dorsal height, and radix height after rhinoplasty. Seventeen patients (26.6%) experienced esthetic dissatisfaction such as deviation, tip depression, bulbous tip, short nose, and nostril asymmetry. Eight patients (12.5%) experienced postoperative difficulty in nasal breathing, and two patients (3.1%) complained of transient nasal pain after rhinoplasty. Six patients (9.4%) underwent revision surgery, and four patients (6.3%) were seriously considering a revision operation.
  
  
  CONCLUSIONS
  The outcome analysis in our series reveals that rhinoplasty in children is complicated by a high rate of revision and esthetic dissatisfaction. The results of this study may indicate that surgeons should have a conservative attitude and apply strict indication in selecting pediatric rhinoplasty candidates.
authors: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea.
authors: Ji Seon
authors: JS
authors: Bae
authors: Eun-Sook
authors: ES
authors: Kim
authors: Yong Ju
authors: YJ
authors: Jang
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009295:Nasal Bone / Q000293:injuries / Q000601:surgery; D009666:Nose / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000175:diagnosis / Q000601:surgery*; D010372:Pediatrics; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D012086:Reoperation / Q000379:methods; D056910:Republic of Korea; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: Children; Growth; Pediatric; Rhinoplasty; Rhinoseptoplasty