Kozmetik Rinoplastinin Gizli Sonuçları: Postoperatif Nazal Obstrüksiyon, Pulmoner Fonksiyonları, Egzersiz Kapasitesini ve Uyku Kalitesini Bozar

Öz

Amaç: Rinoplasti, estetik ve fonksiyonel hedeflerle sıklıkla uygulanan bir cerrahi işlemdir. Ancak bu prosedürün pulmoner fonksiyonlar, egzersiz kapasitesi ve uyku kalitesi üzerindeki olası etkileri yeterince araştırılmamıştır. Mevcut literatürdeki çalışmaların çoğu, cerrahi öncesinde nazal obstrüksiyonu bulunan hastaları incelemektedir. Bu çalışmanın amacı ise, rinoplasti öncesinde herhangi bir fonksiyonel yakınması bulunmayan bireylerde, operasyon sonrasında gelişen nazal tıkanıklığın fizyolojik etkilerini değerlendirmektir. Yöntem: Kesitsel tasarıma sahip bu çalışmaya, 40 rinoplasti hastası (rinoplasti grubu, RG) ile yaş ve cinsiyet açısından eşleştirilmiş 40 sağlıklı birey (kontrol grubu, CG) dahil edilmiştir. Pulmoner fonksiyonlar spirometri ile, egzersiz kapasitesi Artan Yürüyüş Testi (Incremental Shuttle Walk Test, ISWT) ile değerlendirilmiştir. Nazal tıkanıklık şiddeti ve uyku kalitesi; Nazal Obstrüksiyon Semptom Değerlendirme Ölçeği (NOSE), Pittsburgh Uyku Kalitesi İndeksi (PSQI) ve 22 maddelik Sino-Nazal Sonuç Testi (SNOT-22) ile ölçülmüştür. Bulgular: FEV1 değeri RG’de, CG’ye kıyasla anlamlı düzeyde daha düşük bulunmuştur (78.18±6.95 vs. 90.72±6.25; p<0.001). ISWT mesafesi RG grubunda anlamlı şekilde daha kısa (708.75±119.23 m vs. 771.11±160.25 m; p=0.033), HRmax ise daha yüksekti (p=0.026). Ayrıca, NOSE ve PSQI skorları RG’de anlamlı olarak daha yüksek bulunmuştur (sırasıyla p<0.001 ve p=0.004), bu da daha kötü nazal obstrüksiyon ve uyku kalitesi anlamına gelmektedir. FEV1 ile NOSE skoru arasında güçlü negatif korelasyon saptanmıştır (r=-0.885, p<0.001). Sonuç: Bu çalışma, yalnızca estetik amaçlarla rinoplasti geçiren ve cerrahi öncesinde nazal fonksiyonel bir sorun yaşamayan bireylerde, postoperatif dönemde gelişen nazal obstrüksiyonun; solunum fonksiyonlarını, egzersiz kapasitesini ve uyku kalitesini olumsuz etkileyebileceğini göstermektedir. Bulgular, rinoplasti öncesinde kapsamlı bir değerlendirme yapılmasının ve ameliyat sonrası olası fonksiyonel değişikliklerin yakından izlenmesinin önemini ortaya koymaktadır. Gelecekte yapılacak prospektif ve uzun süreli takip çalışmaları, bu etkilerin geçici mi yoksa kalıcı mı olduğunu ortaya koymaya yardımcı olacaktır.

Anahtar Kelimeler

• Rinoplasti
• Nazal Obstrüksiyon
• Pulmoner Fonksiyon
• Egzersiz Kapasitesi
• Uyku Kalitesi

The Hidden Consequences of Cosmetic Rhinoplasty: Postoperative Nasal Obstruction Impairs Pulmonary Function, Exercise Capacity, and Sleep

Öz

Aim: Rhinoplasty is widely performed for aesthetic enhancement, but its potential effects on respiratory health are often overlooked particularly in individuals without prior nasal obstruction. This study aimed to evaluate whether postoperative nasal congestion after cosmetic rhinoplasty affects pulmonary function, exercise capacity, and sleep quality. Material and Methods: A cross-sectional design was used to compare 40 patients who developed nasal congestion after cosmetic rhinoplasty with 40 age- and sex-matched healthy controls. Pulmonary function was assessed using spirometry, and exercise capacity was measured by the Incremental Shuttle Walk Test. Subjective symptoms were evaluated using the Nasal Obstruction Symptom Evaluation (NOSE), Pittsburgh Sleep Quality Index (PSQI), 22-item Sino-Nasal Outcome Test (SNOT-22), and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). Results: Forced expiratory volume in one second (FEV1) was significantly lower in the rhinoplasty group than in controls (78.18±6.95vs. 90.72±6.25, p<0.001). The rhinoplasty group also had a shorter walk distance (708.75±119.23 vs. 771.11±160.25 meters, p=0.033) and higher maximum heart rate (p=0.026). Patient-reported outcomes were significantly worse in the rhinoplasty group, with higher NOSE, PSQI, SNOT-22, and SCHNOS scores (p=0.004, p<0.001, p=0.003, and p=0.030 respectively). A strong negative correlation was observed between FEV1 and NOSE scores (r=-0.885, p<0.001). Conclusion: Even in patients without preoperative functional complaints, postoperative nasal obstruction following cosmetic rhinoplasty may impair pulmonary function, reduce exercise tolerance, and affect sleep quality. The strong association between nasal obstruction severity and FEV1 suggests that airflow limitation has measurable respiratory consequences. These findings highlight the need for preoperative screening and postoperative monitoring in aesthetic rhinoplasty cases. Longitudinal studies are warranted to clarify whether these impairments are temporary or persistent and to develop strategies that support functional recovery.

Anahtar Kelimeler

• Rhinoplasty
• Nasal Obstruction
• Pulmonary Function
• Exercise Capacity
• Sleep Quality

Kaynakça

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