Table 2.
Summary of systematic reviews and meta-analysis retrieved from journals in facial plastic surgery
| Author, Year | Scope | Review Question | Outcomes | Conclusions |
|---|---|---|---|---|
| Wee et al,13 2015 |
Rhinoplasty | Evaluate complications related to autologous rib cartilage rhinoplasty |
Nasal complications, donor-site morbidity, and revision surgery |
Long-term complications and donor-site morbidity rates associated with autologous rib cartilage use in rhinoplasty were low. Because of limitations future studies are needed. |
| Paleri et al,18 2014 |
Microvascular | Evaluated impact of vascularized tissue on fistula rate after laryngectomy reconstruction |
Fistula rate | Flap reconstruction/reinforcement with vascularized tissue reduced their risk of pharyngocutaneous fistula by approximately one-third. |
| Rhee et al,19 2014 |
Rhinoplasty | Define symptomatic, normative, and postoperative values for nasal obstruction |
Nasal obstruction assessed with VAS and NOSE |
VAS and NOSE can be used as a clinically meaningful measure of successful surgical outcomes. |
| da Silva et al,8 2014 |
Perioperative | To determine the effects, including safety, of perioperative administration of corticosteroids for preventing complications following facial plastic surgery in adults |
Ecchymosis and edema | Limited evidence that corticosteroids decrease ecchymosis and edema. There is little evidence regarding the safety of this intervention. |
| Cheung et al,20 2013 |
Trauma | Determine safety and efficacy of endoscopic management of isolated orbital floor fractures |
Resolution of diplopia and enophthalmos, postoperative complications |
Reconstruction of orbital floor fractures through an endoscopic approach seems to be safe and effective. |
| Morris & Kellman,21 2014 |
Trauma (antibiotics) |
Studied role of prophylactic antibiotics in the management of facial fractures |
Postoperative infection rate | Risk of infection in patients with mandibular fractures is reduced with use of prophylactic antibiotics from time of injury to completion of the perioperative course. |
| Picavet et al,22 2011 |
BDD | Assessment of screening tools for BDD in cosmetic surgery setting |
BDD questionnaire-dermatology version, dysmorphic concern questionnaire |
Despite high prevalence of BDD in cosmetic surgery, little is known about these tools in the cosmetic surgery setting. Further research is needed on the prevalence of BDD in cosmetic surgery and impact of BDD on treatment outcomes. |
| André et al,23 2009 |
Rhinoplasty | Studied the relationship between subjective and objective evaluation of the nasal airway |
Rhinomanometry, acoustic rhinometry, patient-reported outcomes |
Patients’ subjective nasal obstruction does not correlate well with rhinomanometry and acoustic rhinometry. There is thus little evidence for routine use of rhinomanometry or acoustic rhinometry for quantifying surgical results in clinical rhinologic practice. |
| Spielmann et al,24 2009 |
Rhinoplasty | Evaluate surgical treatment strategies for nasal valve collapse |
Subjective symptom relief, cosmetic outcome, objective measurements of nasal airway patency |
No randomized controlled trials on nasal valve surgery were identified. Reporting of long-term outcomes is limited. There is uncertainty regarding evidence base for choice of specific technique and duration of benefit. |
| Nash et al,25 2010 |
Trauma/facial nerve |
Evaluate impact of early surgical intervention vs steroid administration/observation |
House-Brackmann scale | The available evidence does not clearly indicate whether surgical vs nonsurgical intervention achieves most favorable outcome for facial paralysis after trauma. |
| Rhee & McMullin,26 2008 |
Measurement | Identify outcome instruments specific for facial plastic surgery interventions and conditions |
Outcome instruments validation | Validated outcome measures are available for common facial plastic surgery conditions. Challenges remain in harmonizing and standardizing the different measures to reach clinically meaningful assessments of outcomes. |
| Rhee et al,27 2008 | Rhinoplasty | Critical review of evidence supporting functional rhinoplasty or nasal valve repair |
Validated patient-reported outcome measures |
Level 4 evidence supports the efficacy of functional rhinoplasty for treatment of nasal obstruction arising from nasal valve collapse. Further studies with standardized objective outcome measures and comparison cohorts are needed. |
| Leventhal et al,28 2006 |
Wound healing | Determine treatments that can improve keloid and hypertrophic scars |
Assessment of keloid and hypertrophic scars |
Most treatments for keloidal and hypertrophic scarring offer minimal likelihood of improvement. |
| Koch & Perkins,29 2002 |
Rhytidectomy/laser | Evaluate the safety of combining carbon dioxide laser resurfacing with full-face rhytidectomy |
Rate of postoperative complications |
Simultaneous rhytidectomy and carbon dioxide laser resurfacing can safely provide a dual cosmetic benefit for aesthetic rejuvenation. |
The journals JAMA Facial Plastic Surgery, Laryngoscope, JAMA Otolaryngology, and Otolaryngology – Head & Neck Surgery were searched using publication type limit to “review,” “systematic review,” or “meta-analysis.” Cochrane library was also searched for related reviews. The titles and abstracts were first screened, and then two reviewers independently identified eligible studies (systematic review or meta-analysis in facial plastic surgery). Subsequently, the data were extracted from each eligible study using standardized form and summarized.
Abbreviations: BDD, body dysmorphic disorder; NOSE, Nasal Obstruction Symptom Evaluation scale; VAS, visual analog scale.