Features of Importance in the Nasal Exam in Rhinoplasty

BACKGROUND: The most critical exam components in patients seeking rhinoplasty have not been established. OBJECTIVE: To identify concordance among experienced rhinoplasty surgeons regarding the most important exam features for various deformities. METHODS: An online questionnaire was distributed to board-certified facial plastic and plastic surgeons experienced in rhinoplasty, with seven nasal deformity categories: dorsal hump, crooked nose, boxy tip, pinched tip, droopy tip, saddle nose, and nonallergic nasal obstruction. For each, respondents were asked to rank the three most important anatomic regions to examine from the following: nasal bones, midvault cartilage, skin, radix, facial profile, lip, tip, septum, internal nasal valve, nostrils, inferior and middle turbinates. For each ranked region, up to three important features were chosen. Normalized Attention Scores (NAS) were calculated to determine agreement amongst surgeons. RESULTS: A total of 13 facial plastic and 8 plastic surgeons were invited to participate and completed the questionnaire. All cases had high agreement demonstrated by NAS, with the dorsal hump case exhibiting the greatest variability in responses. CONCLUSIONS: In this survey of 21 rhinoplasty surgeons, there was general agreement regarding the most relevant anatomical structures and features, which may provide a conceptual foundation for identifying key exam features for seven common complaints in patients seeking rhinoplasty.

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Publication Details

Journal
Facial Plastic Surgery & Aesthetic Medicine
Published
2026-04-17
DOI
https://doi.org/10.1177/26893614261431085
Primary Topic
Nasal Surgery and Airway Studies
Type
article
Field-Weighted Citation Impact
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article

Features of Importance in the Nasal Exam in Rhinoplasty

Ben C. Marcus, Roxana Cobo, Sam L. Oyer, Priyesh N. Patel et al.
Facial Plastic Surgery & Aesthetic Medicine
Nasal Surgery and Airway Studies
article

Features of Importance in the Nasal Exam in Rhinoplasty

Ben C. Marcus, Roxana Cobo, Sam L. Oyer, Priyesh N. Patel, Adam B. Weinfeld, Manish I. Shah, Cherian Kurian Kandathil, Stephen B. Baker, Ali Totonchi, Amit D. Bhrany, José E. Barrera, Emily A. Spataro, Jamil Ahmad, Joe M. Gryskiewicz, R. LAURENCE BERKOWITZ, Steven J. Pearlman, Elizabeth S. Longino, Brian J.F. Wong, Sam P. Most, Rod J. Rohrich, Grant S. Hamilton, Oren A. Friedman, Daniel Knott
article en

Abstract

BACKGROUND: The most critical exam components in patients seeking rhinoplasty have not been established. OBJECTIVE: To identify concordance among experienced rhinoplasty surgeons regarding the most important exam features for various deformities. METHODS: An online questionnaire was distributed to board-certified facial plastic and plastic surgeons experienced in rhinoplasty, with seven nasal deformity categories: dorsal hump, crooked nose, boxy tip, pinched tip, droopy tip, saddle nose, and nonallergic nasal obstruction. For each, respondents were asked to rank the three most important anatomic regions to examine from the following: nasal bones, midvault cartilage, skin, radix, facial profile, lip, tip, septum, internal nasal valve, nostrils, inferior and middle turbinates. For each ranked region, up to three important features were chosen. Normalized Attention Scores (NAS) were calculated to determine agreement amongst surgeons. RESULTS: A total of 13 facial plastic and 8 plastic surgeons were invited to participate and completed the questionnaire. All cases had high agreement demonstrated by NAS, with the dorsal hump case exhibiting the greatest variability in responses. CONCLUSIONS: In this survey of 21 rhinoplasty surgeons, there was general agreement regarding the most relevant anatomical structures and features, which may provide a conceptual foundation for identifying key exam features for seven common complaints in patients seeking rhinoplasty.

Facial Plastic Surgery & Aesthetic Medicine
MetroHealth (US), Ascension (US), Mayo Clinic (US), University of Wisconsin–Madison (US), Palo Alto University (US), Illumina (United States) (US), University of California, San Francisco (US), University of Washington (US), University of California, Irvine (US), Washington University in St. Louis (US), Universidad Santiago de Cali (CO), Plastic Surgery Hospital (CN), Dallas Plastic Surgery Institute (US), Texas Plastic Surgery (US), Cleveland Metroparks (US), Twin Cities Orthopedics (US), Aesthetic Surgery Center (US), Mayo Clinic in Arizona (US), Twin Cities Spine Center (US), Skin Research Center (FR), University of Virginia (US), The University of Texas Southwestern Medical Center (US), MedStar Health (US), Vanderbilt University Medical Center (US), Stanford University (US)
Peace, Justice and strong institutions
Openalex Percentile: Top 22%
Nasal Surgery and Airway Studies
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