R

rhinoplasty Plastic surgery to repair or recon-
struct the NOSE. Surgeons perform rhinoplasty
operations for cosmetic and for reconstructive rea-
sons. Cosmetic rhinoplasty is the most commonly
performed PLASTIC SURGERYprocedure in the United
States, with more than 350,000 operations each
year. Reconstructive rhinoplasty helps restore the
function and appearance of the nose when there
are structural defects such as SEPTAL DEVIATIONor
following serious trauma (such as a BROKEN NOSE)
and conditions such as SKIN CANCERor other can-
cers affecting the nose.
Rhinoplasty is nearly always an AMBULATORY SUR-
GERYperformed under general or local ANESTHESIA.
The surgeon may reshape the CARTILAGEand occa-
sionally the BONE. Swelling and discoloration are
common following the OPERATION, gradually dimin-
ishing over two to three weeks. Bleeding and INFEC-
TIONare among the potential risks of rhinoplasty.
Because the nose has an abundant blood supply,
surgeons typically insert compression packing into
the nose for one to three days after surgery, which
applies pressure to minimize bleeding and maintain
the integrity of the reshaping. The packing carries a
risk of TOXIC SHOCK SYNDROME, a serious systemic
bacterial infection. The surgeon should promptly
evaluate any FEVERor increase inPAIN.
As with any surgery, the results of rhinoplasty
can vary. It is important to understand the limita-
tions and consequences of the operation and to
have realistic expectations for cosmetic results.
Reconstructive rhinoplasty may require several
operations to achieve the desired outcome. Most
people can return to their regular activities within
two weeks.
See also BLEPHAROPLASTY; OTOPLASTY; RHYTIDO-
PLASTY; SURGERY BENEFIT AND RISK ASSESSMENT.

rhinorrhea The medical term for runny NOSE.

Mucus discharge from the nose is the body’s

mechanism for removing foreign matter. Numer-

ous factors can cause rhinorrhea. Among the most

common are exposure to allergens, such as pollen

and dust, and INFECTION, such as COLDS, SINUSITIS,

OTITIS, and PHARYNGITIS. In young children, foreign

objects in the nose also commonly cause rhinor-

rhea. Discharge that contains pus or blood sug-

gests infection.

Clear, watery nasal drainage following

head trauma requires immediate med-

ical attention as this may indicate that

CEREBROSPINAL FLUIDis leaking.

Rebound rhinorrhea can develop with exces-

sive use of nasal sprays as well as oral deconges-

tants and ANTIHISTAMINE MEDICATIONS. When the

doctor can identify the underlying cause, treat-

ment targets that cause. Otherwise, treatment tar-

gets relief of symptoms. Topical decongestants

(nasal sprays) are the treatment of first choice,

applied for a short and defined period of time. The

doctor may also recommend oral decongestants or

antihistamines.

See also BLOWING THE NOSE; EPISTAXIS; FOREIGN

OBJECTS IN THE EAR OR NOSE; SNEEZE/COUGH ETIQUETTE.

ruptured eardrum A tear in the TYMPANIC MEM-

BRANE, or eardrum, that results from trauma of

some kind. The primary symptoms are

• sudden and sharp PAINfrom the EAR


• drainage (when the cause is INFECTION)


• TINNITUS(a ringing or roaring sound)

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