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Granulomatosis With Polyangiitis (Wegener's Granulomatosis) Nasal Reconstruction: Improved Outcomes With No Delay.
- Source :
-
Aesthetic surgery journal [Aesthet Surg J] 2024 Aug 20; Vol. 44 (9), pp. NP620-NP628. - Publication Year :
- 2024
-
Abstract
- Background: Granulomatosis with polyangiitis (Wegener's granulomatosis) causes progressive nasal collapse, nasal obstruction, and central face deformity. It is not known whether cartilaginous nasal reconstruction should be performed immediately or delayed until after disease "burnout."<br />Objectives: The aims of this research regarding nasal collapse due to Wegener's granulomatosis were to (1) assess the functional and aesthetic outcomes following immediate vs delayed nasal reconstruction; and (2) measure the impact of psychosocial well-being (anxiety, depression, social isolation) in immediate vs delayed nasal reconstruction.<br />Methods: Wegener's patients with either immediate or delayed nasal surgery (n = 61) were compared. Functional and aesthetic severity were compared with the validated Standard Cosmesis and Health Nasal Outcome Survey (SCHNOS) score (t test). In addition, Patient-Reported Outcomes Measurement Information System (PROMIS) perioperative and 1-year follow-up surveys were analyzed.<br />Results: At initial consultation, SCHNOS score severity types were similar for both groups (immediate vs delayed): mild 15% vs 15%; moderate 59% vs 60%, and severe 26% vs 25%. Over a 30 ± 4 month period, delayed surgery patients' conditions deteriorated, with a shift from mild to more severe SCHNOS scores, from 25% severe at initial consultation to 85% before surgery. PROMIS scores at presentation were high compared to the general public; by the time of delayed surgery, patients had significantly worsened: anxiety from 28 to 73; depression from 18 to 62; and social isolation from 20 to 80. Although both immediate and delayed groups improved after surgery in functional and psychosocial scores, the immediate surgery group's improvement was superior.<br />Conclusions: Data showed superior functional and aesthetic scores and superior psychosocial indicators with immediate cartilaginous nasal reconstruction, compared with waiting until disease burnout to undergo surgery.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our siteāfor further information please contact journals.permissions@oup.com.)
- Subjects :
- Humans
Female
Male
Middle Aged
Adult
Treatment Outcome
Esthetics
Aged
Time-to-Treatment
Severity of Illness Index
Retrospective Studies
Time Factors
Nose Deformities, Acquired surgery
Nose Deformities, Acquired etiology
Nose Deformities, Acquired psychology
Follow-Up Studies
Depression etiology
Depression diagnosis
Depression psychology
Nasal Obstruction surgery
Nasal Obstruction etiology
Nasal Obstruction diagnosis
Nasal Obstruction psychology
Anxiety etiology
Anxiety diagnosis
Anxiety psychology
Granulomatosis with Polyangiitis surgery
Granulomatosis with Polyangiitis diagnosis
Granulomatosis with Polyangiitis complications
Rhinoplasty methods
Rhinoplasty psychology
Rhinoplasty adverse effects
Patient Reported Outcome Measures
Subjects
Details
- Language :
- English
- ISSN :
- 1527-330X
- Volume :
- 44
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Aesthetic surgery journal
- Publication Type :
- Academic Journal
- Accession number :
- 38768232
- Full Text :
- https://doi.org/10.1093/asj/sjae114