title: Evaluating current functional airway surgery during rhinoplasty: a survey of the American Society of Plastic Surgeons.
abstract: BACKGROUND
  Despite numerous reports outlining technical modifications in rhinoplasty, few publications discuss the importance of the perioperative assessment and surgical management of the nasal airway. This study's objective is to increase awareness regarding the functional aspects of rhinoplasty surgery and to encourage surgeons to incorporate functional airway management into their rhinoplasty practice.
  
  
  METHODS
  A web-based survey was given to all members of the American Society of Plastic Surgeons (ASPS). Survey results were analysed to determine if surgeons' experience, annual rhinoplasty volume, or postgraduate training affected their results. The relationship between surgeon satisfaction with the outcome of the airway management and the frequency of performing an inferior turbinate reduction was investigated.
  
  
  RESULTS
  Of the 4,383 listed ASPS members, 671 (21%) completed the web-based survey. Surgeons who performed a preoperative internal nasal exam were more satisfied with their results (p = 0.016) and report lower rates of postoperative nasal airway obstruction (p = 0.054). Inferior turbinate reduction did correlate to postoperative satisfaction with the nasal airway (p < 0.001). Overall, 85% of respondents were satisfied with their management of the nasal airway and 87% of respondents agreed that there is a need for more instructional courses on this topic.
  
  
  CONCLUSIONS
  There is considerable variation in the results and techniques of assessment and treatment of the nasal airway. Rhinoplasty volume and inferior turbinate reduction are associated with surgeon satisfaction of management of the nasal airway. Functional airway considerations should be incorporated into routine rhinoplasty training, assessment, and treatment.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue; G5/361 Clinical Science Center, Mail Code 3236, Madison, WI, 53792, USA, ahafifi@yahoo.com.
authors: Ahmed M
authors: AM
authors: Afifi
authors: Steve J
authors: SJ
authors: Kempton
authors: Chad R
authors: CR
authors: Gordon
authors: Landon
authors: L
authors: Pryor
authors: Ashraf A
authors: AA
authors: Khalil
authors: Walter M
authors: WM
authors: Sweeney
authors: Shashidhar
authors: S
authors: Kusuma
authors: Claude-Jean
authors: CJ
authors: Langevin
authors: James E
authors: JE
authors: Zins
mesh_terms: D002983:Clinical Competence; D019538:Health Care Surveys; D006801:Humans; D015508:Nasal Obstruction / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D057234:Preoperative Period; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D013518:Surgery, Plastic / Q000193:education; D014420:Turbinates / Q000601:surgery*