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Late-Breaking Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Late-Breaking Scientific Orals: Facial Plastic and Reconstructive Surgery and Pediatric Otolaryngology

Serum Cotinine Concentration as a Measure for Tobacco Use and Outcomes in Septorhinoplasty Procedures

Monday, September 30, 2024
8:24 AM – 8:30 AM EDT
Location: MBCC, 222
Disclosure(s):
Kimberly H. Chan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Shivam D. Patel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Perioperative tobacco use is associated with poor wound healing and postoperative complications. Cotinine is a metabolite of nicotine found in the serum and offers an objective and reliable method to detect tobacco use or exposure. The purpose of this study is to evaluate the complication rates and outcomes in patients with evidence of tobacco consumption compared to patients without evidence of tobacco consumption.

Methods: A prospective study was conducted on patients undergoing septorhinoplasty from December 2017 to January 2023. Patient consent and serum cotinine levels were obtained on the day of surgery. Postoperative wound complications were categorized as mild, moderate, and severe. Preoperative and postoperative nasal obstruction and septoplasty effectiveness (NOSE) scores were assessed. Chi square tests, Fischer Exact tests, and Kruskal-Wallis tests were used to analyze the data.

Results: In total, 67 patients were included. The average age was 46 years old; 31 patients were male, and 36 were female. Of them, 7 patients were current tobacco users, 20 were former users, and 40 were non-tobacco users. Of the total, 13 patients (19%) were cotinine-positive, with an average level of 211.7 ng/mL. There was no significant difference in the change in NOSE scores between the cotinine-positive (-44) and cotinine-negative (-45.3) groups (p = 0.7). Of the 13 cotinine-positive patients, the change in NOSE scores in patients who reported tobacco use was -33.1 compared to -56.7 in patients who did not report tobacco use (p = 0.07). None of the cotinine-positive patients had postoperative wound complications while 4 of the cotinine-negative patients did (2 mild, 2 moderate). Of the cotinine-positive patients, 3 reported recurrent/persistent tobacco use postoperatively compared to two cotinine-negative patients (p = 0.47).

Conclusions: Serum cotinine level offers an objective measure of tobacco use/exposure in the perioperative period. Patients with positive serum cotinine did not have increased rates of postoperative complications or worse NOSE outcomes in septorhinoplasty procedures.

    Presenting Author(s)

  • Kimberly H. Chan, MD

    Resident Physician
    Penn State College of Medicine
    Hummelstown, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Shivam D. Patel, MD

    Resident Physician
    University of Pittsburgh Medical Center - Medical Education Program
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AK

    Allison Keane, MD

    University of North Carolina at Chapel Hill, United States

    Disclosure information not submitted.

  • Jessyka G. Lighthall, MD

    Chief, Division of Facial Plastic & Reconstructive Surgery, Associate Professor
    Penn State College of Medicine
    Hershey, PA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Jessyka G. Lighthall, MD

    Chief, Division of Facial Plastic & Reconstructive Surgery, Associate Professor
    Penn State College of Medicine
    Hershey, PA, United States

    Disclosure information not submitted.