AAO-HNS Improving Nasal Form and Function after Rhinoplasty Guideline Summary

Document Overview

Design and created by Guideline Central in participation with the American Academy of Otolaryngology - Head and Neck Surgery Foundation.

Document Overview

Document Title: Improving Nasal Form and Function after Rhinoplasty

Authoring Society: American Academy of Otolaryngology - Head and Neck Surgery Foundation

Endorsing Societies

American Academy of Facial Plastic and Reconstructive Surgery

American Academy of Pediatrics

American Academy of Sleep Medicine

American Rhinologic Society

American Society of Plastic Surgeons

Society of Otorhinolaryngology and Head-Neck Nurses

Document Publication Date: Feb 1, 2017

Page Last Reviewed/Updated: Sep 1, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599816683153

Source Citation: Ishii LE, Tollefson TT, Basura GJ, et al. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty. Otolaryngology–Head and Neck Surgery. 2017;156(2_suppl):S1-S30. doi:10.1177/0194599816683153

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care.

Scope: Management, Rehabilitation

Diseases/Conditions (MeSH)

D012225 - Rhinoplasty

Keywords: cosmetic surgery, nasal surgery, plastic surgery, rhinoplasty, septorhinoplasty

Target Patient Population: all patients aged ≥15 years

Target Provider Population: any clinician or individual, in any setting, involved in the management of patients who have undergone rhinoplasty

Inclusion Criteria: Male, Female, Adolescent, Adult, Older Adult

Health Care Settings: Ambulatory, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

PICO Questions

What are the short- (<12 months) and long-term (>12 months) metrics showing patient satisfaction and functional outcome improvement following rhinoplasty?
What is the best preoperative assessment to evaluate patients for preoperative comorbidities, including OSA (eg, STOP-BANG, Body Dysmorphic Disorder Questionnaire)?
What is the best measure to evaluate and objectify airway obstruction in rhinoplasty patients?
What is the optimal time to evaluate nasal airway obstruction following rhinoplasty?
What are the data on revision rhinoplasty that include outcomes as they relate to patient expectation and preoperative counseling?
What are the rates of litigation in rhinoplasty and revision rhinoplasty?
What are patients specifically told about surgical expectations?
What mechanism can be used to provide patients with a tool to measure their outcomes versus their satisfaction?
What is the sustained long-term benefit of using a tool to measure outcomes versus patient satisfaction?
What are the best CPAP appliances to use following rhinoplasty as they relate to patient comfort and optimal surgical healing while treating OSA?
When specifically should CPAP be reinstated after rhinoplasty?
What is the optimal duration and dosage of pain medication, including nonsteroidal anti-inflammatory drugs, to use after rhinoplasty?
What is the optimal intraoperative pain medication?
Can the management of acute postoperative pain improve the overall outcomes and patient satisfaction following rhinoplasty?
What are the long-term outcomes of improved patient satisfaction of rhinoplasty as it relates to the acute management of pain and discomfort?
What is the optimal prophylactic antibiotic to be given prior to rhinoplasty?
When used postoperatively, what antibiotic is the best, and what are the data showing optimal efficacy?
What should be the specific steroid and dose given pre- and postoperatively?
Are there increased wound complications or delays in wound healing when steroids are used postoperatively?
Should steroids be given to immune-compromised patients after rhinoplasty?
Do topical nasal steroids improve recovery after rhinoplasty?
What specific packing materials and time frames do rhinoplasty surgeons use?
What are the long-term functional and cosmetic outcomes as they relate to the use of nasal packing in the postoperative period?
What are the specific benefits of nasal packing?
What are the long-term data on validated metrics for patient satisfaction and functional outcome?

Supplemental Methodology Resource: Methodology Supplement

Number of Source Documents: 125

Literature Search Start Date: Friday, May 1, 2015

Literature Search End Date: Tuesday, December 1, 2015

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes