Skip to main content
SpringerLink
Log in

Role of External Nasal Splinting Following Rhinoplasty: Is It Really Important? A Comprehensive Systematic Review of Literature

  • Review
  • Rhinoplasty
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Following rhinoplasty, external nasal splints are used to reshape the cartilage and reposition the nasal bone. Despite the popularity of using an external nasal splint in rhinoplasty procedures, there is still a lack of evidence of the effectiveness of using the external nasal splint post-rhinoplasty. This systematic literature review aimed to evaluate the evidence regarding the use of external nasal splints following rhinoplasty.

Methods

A systematic search of Cochrane, Medline, and Embase databases was conducted in September 2022. The literature was screened independently by two reviewers, and the data were extracted. Our search terms included septorhinoplasty, rhinoplasty, osteotomy, splinting, nasal splinting, and external nasal splinting.

Results

Initially, 1617 articles were identified, but only four articles were included in the final review. The included studies were all published between 2016 and 2021. The included studies recruited 2425 patients, 20 of whom used external splints and 2415 did not. Out of 2415 patients who did not use an external nasal splint, there were 151 patients with moderate periorbital edema and ecchymosis. There was a decrease in nasal width in 99% of the patients who did not use external nasal splinting postoperatively.

Conclusion

According to our findings, nasal splinting should not be routinely used following rhinoplasty, but only in certain patients. There is no clear evidence that nasal splints reduce complications, and complications occurred among both patients with and without external nasal splints. Further studies need to be conducted to confirm this conclusion.

Level of Evidence III

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Challita R, Shouman M, Ghanime G (2019) Rhinoplasty and external nasal splinting: is it really a must? Plast Reconst Surg Glob Open 7(8):e2374. https://doi.org/10.1097/GOX.0000000000002374

    Article  Google Scholar 

  2. Eskitascioglu T, Kemaloglu AC (2010) Skin necrosis in nasal dorsum following rhinoplasty. Eur J Plast Surg 33(1):49–51

    Article  Google Scholar 

  3. Tasman AJ (2007) Rhinoplasty—indications and techniques. GMS current topics in otorhinolaryngology. Head Neck Surg 6:Doc09

    Google Scholar 

  4. Fedok FG (2016) Primary rhinoplasty. Fac Plast Surg Clin 24(3):323–335

    Article  Google Scholar 

  5. Ahn MS, Maas CS, Monhian N (2003) A novel, conformable, rapidly setting nasal splint material: results of a prospective study. Arch Facial Plast Surg 5(2):189–192. https://doi.org/10.1001/archfaci.5.2.189

    Article  PubMed  Google Scholar 

  6. Jayakumar NK, Rathnaprabhu V, Ramesh S, Parameswaran A (2016) Polyvinyl siloxane: novel material for external nasal splinting. Int J Oral Maxillofac Surg 45(1):57–59. https://doi.org/10.1016/j.ijom.2015.08.984

    Article  CAS  PubMed  Google Scholar 

  7. Varedi P, Bohluli B (2015) Do the size and extension of the external nasal splint have an effect on the osteotomy, brow lines, and long-term results of rhinoplasty: a prospective randomized controlled trial of 2 methods. J Oral Maxillof Surg 73(9):1843.e1-1843.e18439. https://doi.org/10.1016/j.joms.2015.05.027

    Article  Google Scholar 

  8. Anastassov GE, Payami A, Manji Z (2012) External fixation of unstable, “flail” nasal fractures. Craniomaxillofac Trauma Reconstr 5(2):99–106. https://doi.org/10.1055/s-0032-1313359

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ong AA, Farhood Z, Kyle AR, Patel KG (2016) Interventions to decrease postoperative edema and ecchymosis after rhinoplasty: a systematic review of the literature. Plast Reconstr Surg 137(5):1448–1462. https://doi.org/10.1097/PRS.0000000000002101

    Article  CAS  PubMed  Google Scholar 

  10. Vidal P, Berner JE (2016) Is rigid nasal splinting needed after rhinoplasties? An 18-year experience using surgical tape. Plast Reconstr Surg 4(12):e1188. https://doi.org/10.1097/GOX.0000000000001188

    Article  Google Scholar 

  11. Kim JS, Kim SH, Hwang SH (2021) Method of lateral osteotomy to reduce eyelid edema and ecchymosis after rhinoplasty: a meta-analysis. Laryngoscope 131(1):54–58. https://doi.org/10.1002/lary.28519

    Article  PubMed  Google Scholar 

  12. Schoinohoriti O, Igoumenakis D, Rallis G (2017) Fractures of the nasal bones: is external splinting really warranted? J Craniofac Surg 28(8):e760–e763. https://doi.org/10.1097/SCS.0000000000003936

    Article  PubMed  Google Scholar 

  13. Moher D, Liberati A, Tetzlaff J et al (2009) PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097

    Article  PubMed  PubMed Central  Google Scholar 

  14. Higgins J, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions, Version 5.1.0. https://training.cochrane.org/handbook. Accessed June 1, 2021

  15. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan—a web and mobile app for systematic reviews. Syst Rev 5(1):1–10

    Article  Google Scholar 

  16. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for nonrandomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73(9):712–716

    Article  PubMed  Google Scholar 

  17. Murad MH, Sultan S, Haffar S, Bazerbachi F (2018) Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med 23(2):60–63

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cabbarzade C, Yücel ÖT, Sözen T, Ozgen B (2021) External splinting is not mandatory after all rhinoplasties: a prospective randomized trial. Ann Plast Surg 86(4):376–380. https://doi.org/10.1097/SAP.0000000000002710

    Article  CAS  PubMed  Google Scholar 

  19. Vulović D, Kozarski J, Radivojčević U, Stepić N, Milićević S, Petrović NT (2018) Rhinoplasty without nasal packing and splinting. Vojnosanit Pregl 75(4):352–358

    Article  Google Scholar 

  20. Sullivan D, Chung KC, Eaves FF III, Rohrich RJ (2011) The level of evidence pyramid: indicating levels of evidence in plastic and reconstructive surgery articles. Plast Reconstr Surg 128(1):311–331

    Article  CAS  PubMed  Google Scholar 

  21. Al Arfaj AM (2015) The use of nasal packing post rhinoplasty: does it increase periorbital ecchymosis? A prospective study. J Otolaryngol Head Neck Surg 44(1):1–4

    Article  Google Scholar 

  22. Dubin MR, Pletcher SD (2009) Postoperative packing after septoplasty: is it necessary? Otolaryngol Clin North Am 42(2):279–285

    Article  PubMed  Google Scholar 

  23. Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87(11):624–627

    Article  PubMed  Google Scholar 

  24. Bouaoud J, Loustau M, Belloc JB (2018) Functional and aesthetic factors associated with revision of rhinoplasty. Plast Reconstr Surg Glob Open 6(9):e1884

    Article  PubMed  PubMed Central  Google Scholar 

  25. Calvert JW, Patel AC, Daniel RK (2014) Reconstructive rhinoplasty: operative revision of patients with previous autologous costal cartilage grafts. Plast Reconstr Surg 133(5):1087–1096

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Funding

The authors do not have any conflict of funding to declare.

Author information

Author notes

  1. Mohammed Khan and Hatan Mortada have contributed equally and are joint first authors.

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia

    Mohammed Khan

  2. Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia

    Hatan Mortada

  3. Department of Plastic Surgery and Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia

    Hatan Mortada

  4. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    Bassam AlRajhi

  5. College of Medicine, King Saud University for Health Sciences, Jeddah, Saudi Arabia

    Alhanouf Alwagdani

  6. Department of Otolaryngology, Head and Neck Surgery, Alnoor Specialist Hospital, Makkah, Saudi Arabia

    Wedyan Almosa

  7. Division of Otolaryngology, Department of Surgery, National Guard King Abdulaziz Hospital, Alahsa, Saudi Arabia

    Khaled Almolhim

  8. Division of Facial Plastic Surgery, Department of Otolaryngology–Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia

    Amani A. Obeid

  9. Division of plastic surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia

    Omar Fouda Neel

  10. Division of plastic surgery, Department of Surgery, McGill University, Montreal, Canada

    Omar Fouda Neel

Authors
  1. Mohammed Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hatan Mortada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bassam AlRajhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alhanouf Alwagdani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wedyan Almosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Khaled Almolhim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Amani A. Obeid
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Omar Fouda Neel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hatan Mortada.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

Not applicable due to the nature of the study.

Informed Consent

Not applicable due to the nature of the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khan, M., Mortada, H., AlRajhi, B. et al. Role of External Nasal Splinting Following Rhinoplasty: Is It Really Important? A Comprehensive Systematic Review of Literature. Aesth Plast Surg 47, 2642–2650 (2023). https://doi.org/10.1007/s00266-023-03317-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-023-03317-y

Keywords

Search

Navigation