外鼻形成術における周術期評価—男性と女性の違いを含めて—

Perioperative Evaluation for Rhinoplasty

はじめに

　外鼻形成術では，整容面の改善が鼻機能へ影響することを常に留意することが治療の成功に不可欠である。術前に鼻症状の整容面と機能面を正確に評価する必要があり，そのためには患者の「鼻の曲がり」や「鼻づまり」といった主観的評価と，画像検査や内視鏡検査による客観的評価をすり合わせることで適切な治療選択ができる。当院では鼻中隔外鼻形成術によって機能と整容の改善を両立させることを目指して治療を行っており，周術期検査としてCTや内視鏡検査に加えてアンケートによる鼻症状の主観的評価を用いている。その有用性を含めた外鼻形成術の周術期評価方法について報告する。

　A rhinoplasty often improves the patientʼs self-esteem and quality of life. However, even when surgical outcomes are optimal, there can be discrepancies between patientsʼ and surgeonsʼ satisfaction levels. This is frequently influenced by factors on the patientʼs side, such as gender. When a surgeon performs a rhinoplasty, it is crucial to consider that enhancing the noseʼs appearance can affect its function. It is thus necessary to obtain a precise pre-rhinoplasty assessment of both the cosmetic and functional aspects of nasal symptoms. A discussion of the patientʼs self-assessment of his/her nose is also important, in part to identify issues such as ʻobstructionʼ or a ʻcrooked nose,ʼ with an evaluation conducted by medical experts. Together with CT scans and endoscopy, we use the Japanese version of the Standardized Cosmesis and Health Nasal Outcomes Survey ( J-SCHNOS) questionnaire as part of our perioperative evaluation. We present our perioperative rhinoplasty evaluation method and discuss discrepancies in patient satisfaction with surgery based on gender.