Analysis of the operative utilization of concurrent rhinoplasty and endoscopic sinus surgery

Amit Kochhar, Yanchen Zhang, Laurel Fisher, Patrick Byrne, Stephanie Shintani Smith, Elisabeth H. Ference*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives/Hypothesis: To quantify and analyze the concurrent performance of rhinoplasty (RP) (with or without septoplasty) and functional endoscopic sinus surgery (FESS). Study Design: Cross-sectional analysis. Methods: Current Procedural Terminology codes were used to extract cases of RP (n = 22,360), FESS (n = 99,173), and concurrent RP with FESS (RP + FESS) (n = 1,321) within the State Ambulatory Surgery Databases of California, Florida, Maryland, and New York from 2009 to 2011. Patient demographics, surgeon volume, charge, concurrent nasal procedures, and operating room (OR) time were compared. Results: Among the 1,321 RP + FESS combination cases, a majority involved primary rhinoplasty (n = 697, 52.8%), followed by nasal valve repair (n = 563, 42.6%) and revision rhinoplasty (n = 61, 4.6%). High-volume (n > 30), medium-volume (n = 10–30), and low-volume rhinoplasty surgeons (n ≤ 9) were observed to perform a similar number of FESS + RP combination surgeries (153, 152, and 155, respectively). A majority of RP + FESS involved two or fewer sinuses (65%). Mean OR time for RP + FESS was 189.4 ± 4.2 minutes, approximately 50 minutes shorter than the sum of standalone RP performed individually (138.8 ± 1.0 minutes) and standalone FESS (102.9 ± 0.4 minutes). Conclusions: RP + FESS more frequently involved fewer sinuses (compared with FESS alone) and was also less likely to involve revision rhinoplasty (compared with rhinoplasty alone); therefore, these cases may be selected for lower sinus disease burden and less complex rhinoplasty compared to standalone procedures. Procedures combining rhinoplasty and sinus surgery had a reduction in OR time compared to the hypothetical sum of two standalone procedures. Level of Evidence: NA. Laryngoscope, 130:E311–E319, 2020.

Original languageEnglish (US)
Pages (from-to)E311-E319
Issue number5
StatePublished - May 1 2020


  • State Ambulatory Services and Surgery Database
  • cost
  • rhinoplasty
  • sinus surgery

ASJC Scopus subject areas

  • Otorhinolaryngology


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