Sam P Most

Sam P Most
Stanford University | SU · Department of Otolaryngology

Doctor of Medicine

About

231
Publications
37,535
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3,696
Citations
Citations since 2017
124 Research Items
2224 Citations
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20172018201920202021202220230100200300400500

Publications

Publications (231)
Article
Study Design: Technical note. Objective: The lower nasal architecture is dependent on caudal septal integrity. Deviations of the caudal septum can compromise nasal airflow. The presence of anterior nasal spine deviations contributes to septal and medial crural shifting with ipsilateral encroachment. It is essential to identify nasal spine deviation...
Article
Introduction: The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire is a tool developed to evaluate functional and aesthetic components of rhinoplasty. It is a reliable patient-reported outcome measure, not available in the European Portuguese language. Objective: our goal was to translate and culturally adapt the SCH...
Chapter
Nasal septal deviation is a common problem and one that can significantly affect quality of life. As such, septoplasty is a commonly performed procedure. Although standard septoplasty is sufficient treatment for the majority of septal deviations, when the caudal septum is involved, alternative techniques are often required. This chapter will detail...
Chapter
The dorsal hump is the most common complaint in patients presenting for cosmetic rhinoplasty. Component hump reduction is the technique where a dorsal hump is removed in an incremental top-down fashion. In this chapter you will find the indications, precise technique, and an illustrated case example of incremental hump reduction, with particular at...
Article
Background Patient satisfaction is an essential outcome measure after a rhinoplasty. Yet differences of opinions between rhinoplasty patients and surgeons on nasal aesthetic appearance are unknown. Objectives To determine the differences between patients and surgeons in the perception of nasal aesthetic appearance. Methods A retrospective cohort...
Article
Importance Although septal deviations are highly prevalent in the pediatric population and pediatric septoplasties are garnering more discussion, to date, there are no large-scale studies characterizing pediatric septoplasty revision rates. Objective To identify rates of pediatric septoplasty revision in the US. Design, Setting, and Participants...
Article
Background: Structural preservation techniques (SPR) minimize disruption of the dorsal aesthetic lines, with potential aesthetic and functional benefits over conventional hump resection techniques (CHR). The goal of this study is to compare patient reported outcomes between these techniques. Methods: This study was a retrospective matched cohort...
Article
With no consensus document or guideline to help us compute the psychological make-up of rhinoplasty candidates and in the light of new perspectives of some key opinion leaders in the field of patient selection, the goals of this article are to offer a glimpse of the current literature together with the knowledge gaps, introduce some new tools for t...
Article
Purpose of review: The role of perichondrium in cartilage graft survival has been long debated. Although the innate function of perichondrium in providing mechanical and regenerative support to cartilage in its native position is relatively undisputed, studies continue to vacillate over how the perichondrium effects cartilage grafts once transplan...
Article
Background: Large-scale studies characterizing septoplasty revision rates are lacking. Objectives: To identify rates of septoplasty revision in the United States. Methods: Patients undergoing initial septoplasty between January 1, 2007 and December 31, 2013 were identified using the IBM® MarketScan® Commercial Database. Patients were excluded if th...
Article
Background The aim of this study was to systematically evaluate the evidence of surgical outcomes and complications of spreader grafts and autospreader flaps in the context of middle vault reconstruction after dorsal hump removal.Material and MethodsA systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of...
Article
BackgroundsRhinoplasty necessarily concerns functional and cosmetic aspects, and outcomes of both should be assessed in each patient. There has been a lack in the literature in Italian for a comprehensive tool for assessing both aspects of rhinoplasty. The objective is to translate and validate the Standardized Cosmesis and Health Nasal Outcomes Su...
Article
I read with interest Eravci et al’s article, “Computed Tomography Analysis of Nasal Anatomy in Dorsal Preservation Rhinoplasty.” ¹ The authors undertook a retrospective evaluation of the computed tomography (CT) scans of 203 consecutive rhinoplasties, measuring the nasal bone thickness, the distance between the transverse osteotomy line and the K a...
Article
There has been a resurgence in dorsal preservation rhinoplasty (DPR) caused by theoretic aesthetic and functional advantages compared with conventional hump takedown rhinoplasty. Classically, the push-down and let-down maneuvers have been described for management of the bony nasal vault. There have been a variety of modifications in the septal rese...
Article
The crooked nose is a challenging esthetic and functional problem. The surgeon must carefully evaluate baseline facial asymmetry as well as whether deviation stems from the upper third, middle third, or lower third of the nose. Surgical intervention should be tailored accordingly, with techniques geared toward addressing each deviated section. Modi...
Article
Nasal airway obstruction is a very common phenomenon that can significantly decrease patients' quality of life. This review article summarizes in an evidence-based fashion the diagnosis and treatment of nasal airway obstruction. The nasal airway may be obstructed at the level of the nasal valve, septum, nasal turbinates, sinonasal mucosa, or nasoph...
Article
Background: The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a validated patient-reported outcome measure that evaluates subjective cosmetic and functional complaints. The goal of this study was to compare scores between patients with and without nasal complaints. Methods: This is a retrospective review of SCHNOS-O (obstructiv...
Article
Background: Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. Materials and Methods: An 11-item questionnaire was electronically distributed to...
Article
Background: The voice signals a tremendous amount of gender cues. Transfeminine individuals report debilitating quality-of-life deficits as a result of their vocal gender dysphoria.Aims: We aimed to quantify the potential impact of this dysphoria experienced with quality-adjusted life years (QALYs), as well as associated treatments, through validat...
Article
Background: The coronavirus disease of 2019 (COVID-19) pandemic has widely affected rhinosurgery, given the high risk of contagion and the elective nature of the aesthetic procedure, generating many questions on how to ensure safety. The Science and Research Committee of the Rhinoplasty Society of Europe aimed at preparing consensus recommendation...
Article
Classic Joseph hump reduction techniques have been a hallmark of current rhinoplasty practice and teaching. Recently, there has been a renewed global interest in preservation rhinoplasty techniques, although these techniques are not new. The work and techniques of innovative surgeons including Goodale, Lothrop, and Cottle describing preservation co...
Article
Dorsal preservation rhinoplasty requires precise management of the osseocartilaginous vault. Ultrasonic piezo instruments offer several advantages compared with traditional tools such as hand saws, rasps, and osteotomes. As always, an understanding of the dynamics of manipulation of the vault, anatomy, and proper technique are paramount and are rev...
Article
There has been particular recent interest in dorsal preservation rhinoplasty techniques because of claims of superior functional and aesthetic results relative to conventional hump reductions. The septum in dorsal preservation rhinoplasty is managed in a variety of ways with differences largely based on the location of septal excision (subdorsal re...
Article
Dorsal preservation rhinoplasty has aesthetic advantages over conventional hump takedown rhinoplasty. In dorsal preservation surgery, the nasal vault is treated en bloc. The internal nasal valve angle is not disrupted and there is no need for midvault reconstruction. Two techniques for management of the bony vault exist in dorsal preservation surge...
Article
Objectives/Hypothesis To evaluate the lateral nasal wall stability, nasal function, and cosmesis when creating an aesthetically pleasing nasal tip subunit utilizing lateral crus (LC) altering procedures. Study design Retrospective cohort. Methods In this retrospective cohort study, cosmetic rhinoplasty patients undergoing LC procedures with avail...
Article
Full-text available
Objectives To determine whether hearing aid (HA) use affects social perceptions of general public adults and age‐matched peers and if so, determine if effects are modulated by lack of societal representation of pediatric HAs. Methods A 10‐year‐old boy was presented in six photographic conditions with and without HAs and eyeglasses (a worn sensory...
Article
Background Although prior studies have identified a low risk of venous thromboembolism (VTE) in rhinoplasty, these studies are limited by small samples, and associated risk factors remain unknown. Objective We sought to discern the incidence of VTE following rhinoplasty in a large patient population using a nationwide insurance claims database. M...
Article
Background: In Rhinoplasty, understanding patient expectations are pivotal in achieving an optimal surgical outcome. Objective: To understand preoperative expectations and postoperative satisfaction in patients undergoing rhinoplasty for functional, aesthetic, or both. Method: Adult patients undergoing functional, aesthetic, or combined rhinoplasty...
Article
Full-text available
Reconstructive procedures in the head and neck can be a surgical challenge owing to the complex anatomical and physiological structure. Different locoregional and microvascular flaps are used for various defects to improve both function and cosmesis. Subjective clinical findings have been the mainstay for perfusion monitoring; however, areas of bor...
Article
Background Psychiatric comorbidity is associated with greater 30-day postoperative complication rates in various surgical specialties, but is not well characterized for reconstructive plastic surgery. Objective To compare reconstructive plastic surgery rates and 30-day postoperative complications between patients with and without psychiatric diagn...
Article
The American Society of Plastic Surgeons (ASPS), American Academy of Otolaryngology-Heand and Neck Surgery (AAO-HNS), and the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) commissioned the multi-disciplinary Rhinoplasty Performance Measure Development Work Group to identify and draft quality measures for the care of patient...
Article
Objectives/Hypothesis: The face is a major communicator of gender identity. Transfeminine individuals report debilitating quality-of-life deficits as a result of their gender dysphoria, which may be addressed with feminizing therapies. We aimed to quantify the potential impact of facial gender dysphoria experienced by transfeminine patients, as wel...
Article
Background It would be useful if existing tools or outcomes measures could predict which patients are at greater risk of revision surgery following rhinoplasty Objective We aim to determine if a single question assessing nasal self-esteem could be used to predict which patients are at greatest risk of revision surgery following rhinoplasty Method...
Article
Background: Septal extension grafts (SEGs) are used widely in rhinoplasty as a means of controlling tip position. Grafts positioned in a side-to-side configuration may cause nasal airway obstruction. Methods: Retrospective cohort analysis of patients undergoing cosmetic rhinoplasty. Patients undergoing SEG placement were grouped according to comple...
Article
Objectives/Hypothesis To explore the natural history of nasal obstruction and cosmesis following rhinoplasty by utilizing the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). Study Design Retrospective chart study. Methods This study was carried out at a tertiary referral center, preoperative and postoperative Nasal Obstruction Sy...
Article
Objective: This study sought to prospectively determine the effect of intranasal steroids versus placebo on nasal obstruction in septal deviation. Methods: This was a single-center randomized placebo-controlled double-blind trial with crossover in which all study participants received 6 weeks of therapy with Nasacort (Chattem, Inc.) and with Ayr sa...
Article
Background: In light of the current selfie craze, driven primarily by social media platforms, there is an absolute need among facial plastic surgeons to consider the role of these social platforms in patient counseling regarding their cosmetic requirements. Objectives: Is there a difference in how people are perceived when their image is viewed as...
Article
Article Summary The paramedian forehead flap is a major workhorse for reconstruction of medium to large-sized nasal defects. The tissue bridge that results from the vascular pedicle results in significant cosmetic deformity, with associated social and occupational costs to the patient. This prospective cross sectional study sought to assess efficac...
Article
Objectives: To examine the social perception of microtia and quantify the effect of reconstruction on socially perceived attributes. Methods: Parental consent was obtained for peri-reconstruction photographs in a patient with unilateral grade 3 microtia without an underlying craniofacial syndrome. With computer simulation, the normal, preoperati...
Article
Objectives/hypothesis: Deviations of the caudal nasal septum can impact airflow and aesthetics. The anterior septal reconstruction (ASR) technique, a modification of extracorporeal septoplasty, addresses this issue while preserving a segment of the dorsal septum. When ASR is combined with dorsal hump reductions and osteotomies, the keystone may be...
Article
Full-text available
Importance: Although conventional hump resections are a hallmark of rhinoplasty, there has been a rekindled interest in dorsal preservation (DP) techniques as a means for addressing the dorsal hump, with claims of superior functional and aesthetic results. As such, an understanding of DP, including technical considerations and outcomes, is imperati...
Article
Background This study evaluates the impact of different hump takedown techniques, namely the conventional hump resection with midvault reconstruction, the push-down (PD) and the let-down (LD) procedures, on the INV dimensions. Methods In this cadaveric study, six heads were divided randomly into either the conventional hump resection technique (Gr...
Article
Objectives/hypothesis: To describe a novel technique for tip plasty and determine its efficacy using validated patient-reported outcome measures and objective measures. Study design: Retrospective cohort study. Methods: This study was carried out at a tertiary center. Patients undergoing tip plasty using the miniature lateral crural strut graf...
Article
Nasal obstruction is a common presenting symptom of patients seen by primary care physicians, otolaryngologists, and facial plastic surgeons. A variety of treatment strategies, both surgical and nonsurgical, have been used with success in improving nasal obstruction and quality of life. In a subset of patients, many of whom have either attempted th...
Article
Facial plastic surgeons must understand nasal aesthetics in the context of race, ethnicity, and culture. The lack of aesthetic norms and ideal standards in non-Caucasian patients and the variation in nasal anatomy and morphology among races can create a challenge in approaching ethnic rhinoplasty. Preoperative assessment of nasal and facial feature...
Article
Background Identifying mental health disorders, including body dysmorphic disorder (BDD), is important prior to rhinoplasty surgery, however, these disorders are underdiagnosed, and screening tools are underutilized in clinical settings. Objective To evaluate the correlation of a rhinoplasty outcomes tool (SCHNOS) with psychiatric screening tools....
Article
Full-text available
Background The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a validated questionnaire that assesses functional and aesthetic outcomes of rhinoplasty patients. There are 274 million French speakers worldwide, and this questionnaire is currently not available in French. The purpose of this study was to translate, adapt, and vali...
Article
Full-text available
The Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) is a validated questionnaire that is used as a screening tool for body dysmorphic disorder (BDD) in aesthetic rhinoplasty patients. The BDDQ-AS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients wer...
Article
Objective: Facial nerve injury is a primary complication of open surgical management of condylar fractures. A new modification of the retromandibular transparotid approach, the "biportal transparotid dissection" (BTD), was developed to reduce these injuries in accidental nerve exposure. Design: Prospective cohort study. Setting: Tertiary refer...
Article
Introduction Repair of nasal defects is technically challenging due to inelastic nasal skin and unforgiving nasal geometry. The bilobe flap is a double transposition flap which can transpose skin from cephalad to caudad to repair defects of the lower third of the nose. However, pincushioning may complicate this flap, yielding untoward aesthetic out...
Article
Importance Best practices for antibiotic use after facial plastic and reconstructive procedures have been the subject of much debate, and there is a need for large-scale data to guide further development of evidence-based guidelines for antibiotic use in this setting. Objective To assess patterns of postoperative antibiotic prescriptions and infec...
Article
Importance While extracorporeal septoplasty (ECS) and its modifications have been previously studied, to our knowledge, no systematic review of surgical outcomes and complications of this technique has been performed. Objective To evaluate the evidence of surgical outcomes and complications of ECS (including modified techniques) to treat severe L-...
Article
In Reply Thank you, Dr Pisano, for your insightful comments regarding our recent article. It is true that large analyses such as this should be examined critically and with an understanding of the limitations of large data sets. Regarding surgery duration, we did not adjust the analysis by surgery duration or use of regional blocks. While these cou...
Article
Full-text available
Background Cosmetic rhinoplasty has been linked to iatrogenic breathing disturbances using clinical tools. However, few studies have evaluated outcomes using validated, patient-centered instruments. Objective We aim to determine the incidence and severity of nasal obstruction following cosmetic rhinoplasty as measured by patient-centered, disease-...
Article
Full-text available
Objectives: To examine 12-month outcomes for in-office treatment of dynamic nasal valve collapse (NVC) with a bioabsorbable implant. Study design: Prospective, multicenter, nonrandomized study. Methods: One hundred sixty-six patients with severe-to-extreme class of Nasal Obstruction Symptom Evaluation (NOSE) scores were enrolled at 16 U.S. cli...
Article
Importance The social perception of nasal dorsal modification for male rhinoplasty is poorly understood. Objective To investigate the association of modifying the male nasal dorsum with the perception of such social attributes as youth, approachability, healthiness, masculinity/femininity, intelligence, successfulness, and leadership. Design, Set...
Article
Full-text available
Purpose To compare the surgical outcomes of modified extracorporeal septoplasty and anterior septal reconstruction for the management of the severe deviated nose. Methods In a prospective cohort study, we selected 86 patients referred for septorhinoplasty to a tertiary center in May 2015–April 2017 with a primary complaint of nasal obstruction and...
Article
Nasal obstruction is one of the most common clinical problems encountered by otolaryngologists and facial plastic surgeons. Lateral wall insufficiency (LWI)is a key anatomic contributor to nasal obstruction. Traditional techniques for correcting LWI include alar batten grafts, bone-anchored sutures, and lateral crural strut grafts. Latera is an abs...
Article
Full-text available
Objective: To determine the contribution of the nasal floor and hard palate morphology to nasal obstruction for nonresponders to prior intranasal surgery. Study design: Retrospective case-control study. Setting: Tertiary academic center. Methods: Institutional review board-approved, retrospective institutional database analysis was obtained...
Article
Importance Paramedian forehead flaps are commonly used to reconstruct facial defects caused by skin cancers. Data are lacking on the complications from this procedure, postoperative outcomes, and association of cancer diagnosis with rate of deep venous thrombosis (DVT). Objectives The primary objective was to determine complication rates after par...
Article
Background The minimal clinically important difference (MCID) for the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) has not been determined. Objective To define the MCID for both domains of the SCHNOS questionnaire. Methods This prospective cohort study included patients who underwent functional, cosmetic, or combined rhinoplast...
Article
Importance: Although the development of persistent opioid use after surgical procedures has garnered much attention in recent years, large-scale studies characterizing patterns of persistent opioid use among patients undergoing plastic and reconstructive surgery procedures are lacking. Objective: To assess the prevalence of immediate and long-te...
Article
Full-text available
Background:. The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire is a new instrument that was developed to evaluate both functional and cosmetic components of rhinoplasty. It is a reliable, consistent, and validated patient-reported outcome measure that is not available in Spanish. Methods:. The SCHNOS questionnaire wa...
Article
Full-text available
Importance Periorbital sequelae are a significant source of early postoperative morbidity after rhinoplasty, particularly after an osteotomy is performed. Objective To compare postoperative periorbital sequelae after external perforating lateral osteotomy in rhinoplasty using a periosteal sweeping vs a periosteal preserving approach. Design, Sett...
Article
Importance Assessment of melolabial flap perfusion using indocyanine green (ICG) angiography for nasal reconstruction has not been previously described. Objective To assess melolabial flap relative perfusion using ICG angiography in nasal reconstruction and highlight its clinical relevance. Design, Setting, and Participants In this retrospective...
Article
Importance Identifying factors affecting forehead flap neovascularization during nasal reconstruction surgical procedures using quantitative dynamics of fluorescence from indocyanine green angiography may be associated with reduced vascular complications. Objectives To identify quantifiable forehead flap perfusion measures using indocyanine green...
Article
The objective of this article was to compare the effect of such sociodemographic factors as gender, age, marital status, employment status, race, and income on short- and long-term rhinoplasty outcomes using a validated disease-specific instrument—Nasal Obstruction Symptom Evaluation (NOSE) scale, as well as complication and revision rates. Patient...
Article
This article compares outcomes in patients presenting for either primary or secondary (revision) anterior septal reconstruction (ASR) to treat caudal septal deviation. Patients undergoing ASR by senior author (S. P. M.) between January 1, 2012 and September 1, 2017, with both preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE...
Article
Importance Although antibiotic prophylaxis following rhinoplasty is widespread, the evidence on antibiotic prophylaxis effectiveness and the superiority of particular administration regimens is controversial. To date, a meta-analysis on the topic has not been performed. Objective To systematically review the association between use of preventive a...
Article
Full-text available
The 10-item Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) has recently been introduced as an instrument for describing the severity of nasal obstruction and the extent of aesthetic dissatisfaction.¹ The SCHNOS has demonstrated psychometric validity using both item-response theory and factor analysis.²,3 The instrument is easy to c...
Presentation
ICG angiography is an effective method to determine relative neovascularization perfusion of melolabial flaps Mean perfusion of MLF was 89% after pedicle clamping Future applications Use in patients at high risk of flap necrosis Early flap division and minimize time between stages.
Presentation
External perforating osteotomies without PO sweeping showed less lid edema and ecchymosis in early postop period Further studies on a wider scale are needed
Article
A central component of successful rhinoplasty surgery is maintaining or increasing tip support, as well as addressing tip projection and rotation. The tongue-in-groove (TIG) technique is a method to achieve this goal and has been most extensively described by Kridel and colleagues in 1999.¹ This method uses sutures to create a strong connection bet...