Rhinoplasty for Sinonasal Deformities in Granulomatosis with Polyangiitis: A Systematic Review and Meta-Analysis.

Autor:	Alanazi F; Department of Otolaryngology Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh.; Department of Otolaryngology Head and Neck Surgery, Prince Mohammed Medical City, Jouf., Alenezi M; Department of Otolaryngology Head and Neck Surgery, Collage of Medicine, Qassim University, Buriyadh, Qassim., Alanazy S; Department of Surgery, Ears Nose and Throat Unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah., Yahya B; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2023 Nov-Dec 01; Vol. 34 (8), pp. 2347-2351. Date of Electronic Publication: 2023 Sep 04.
DOI:	10.1097/SCS.0000000000009721
Abstrakt:	Background: Granulomatosis with polyangiitis (GPA) is a vasculitis that affects respiratory and kidney vessels. It primarily involves the nose and sinuses but can progress systemically. Granulomatosis with polyangiitis causes severe nasal deformities, impacting aesthetics and breathing. Literature focuses on rhinoplasty for saddle nose deformities in non-GPA patients, but its suitability for GPA patients remains uncertain. Aim: Our study aims to assess the effectiveness and safety of rhinoplasty in GPA patients by analyzing the existing literature. Methods: Four databases were searched; 2 reviewers independently screened the retrieved references, then relevant data for our study were extracted. Categorical outcomes were analyzed using pooled proportions and 95% CI. Statistical heterogeneity was assessed using the I2 statistics χ 2 test with a P -value lower than 0.1 indicating heterogeneity. Results: In our systematic review and meta-analysis, we incorporated 16 studies encompassing 136 patients who underwent nasal reconstruction as part of their treatment for GPA. The collective findings indicate a favorable success rate for rhinoplasty, with a pooled ratio of 89% (95% CI: 84%, 95%). The rate of revision surgeries was relatively low, with a pooled rate of 19% (95% CI: 12%, 26%). Furthermore, rhinoplasty demonstrated comparatively lower rates of recurrence (pooled rate: 22%, 95% CI: 3%, 42%) and complications (pooled rate: 12%, 95% CI: 7%, 18%). Conclusion: Rhinoplasty benefits GPA patients with saddle nose deformity and septal perforation with high success rates and low recurrence, revision, and complication outcomes. However, more research is needed for validation and refinement. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu