Preservation Rhinoplasty Versus Structural Rhinoplasty in Dorsal Hump Reduction: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Background: A systematic comparison between the preservation rhinoplasty (PR) and the conventional structural rhinoplasty (SR) technique for hump nose correction is still lacking. Objective: To compare among patients undergoing rhinoplasty for dorsal hump correction using structural versus preservation techniques, as measured by functional and cosmetic patient-reported outcomes. Methods: Comprehensive literature search was conducted across PubMed, Medline, Embase, and Cochrane databases using medical subject heading terms. Among patients undergoing dorsal hump reduction, we analyzed randomized controlled trials (RCTs) comparing PR and SR to assess functional and cosmetic satisfaction using the Standardized Cosmesis and Health Nasal Outcomes Survey, and the visual analogue scale. Results: Among the 38 studies initially screened, four RCTs with 419 patients met the inclusion criteria. PR showed significant superiority over SR in both functional (standardized mean difference or SMD −0.317 [95% confidence interval or CI −0.509 to −0.124]) and cosmetic (SMD −0.460 [95% CI −0.851 to −0.069]) outcomes. Functional outcomes exhibited low heterogeneity ( I 2 = 0%), while cosmetic outcomes showed moderate heterogeneity ( I 2 = 67%). Conclusion: In this review, the data suggest that PR might provide both functional and cosmetic satisfactions in dorsal hump reduction compared with SR.