Yesim Esen Yigit Kocer

Background and Objectives: Achieving long-term stability of nasal tip rotation and projection remains a challenge in rhinoplasty because of postoperative remodeling processes such as edema resolution, soft tissue redraping, and scar maturation. This study evaluated the temporal changes in nasal tip rotation and projection following rhinoplasty using the Pentagonal Tip Support Technique (PTST). Materials and Methods: A retrospective analysis was conducted on patients undergoing primary rhinoplasty using PTST, with standardized photographic assessments performed intraoperatively and at 6 and 12 months postoperatively. Nasal tip rotation and projection were quantified using the nasolabial angle and Goode ratio, respectively, and temporal changes were analyzed across postoperative intervals. Results: Both parameters demonstrated statistically significant reductions over time. However, the majority of changes occurred within the first 6 months, whereas later follow-up intervals demonstrated smaller changes and a reduced rate of change. Similar temporal patterns were observed across different skin types, and skin type was not significantly associated with late postoperative changes in rotation or projection. Conclusions: The findings of the present study suggest that PTST is associated with a temporal pattern characterized by greater early postoperative changes followed by smaller interval changes during later follow-up. These findings may reflect postoperative healing dynamics and structural support behavior following rhinoplasty. However, further prospective comparative studies are needed to better define the clinical behavior of PTST over extended follow-up periods relative to established structural rhinoplasty techniques.

Background/Objectives: Caregiver burden represents a critical yet under-integrated dimension of clinical care in head and neck cancer, where complex treatments and functional impairments impose substantial demands on informal caregivers. This study aimed to evaluate caregiver burden and to identify its clinical and psychological correlates among caregivers of patients with head and neck cancer. Methods: This prospective cross-sectional study included 132 caregivers. Caregiver burden was assessed using the Zarit Burden Interview, and psychological distress was evaluated using the Hamilton Depression (HAM-D) and Anxiety (HAM-A) Rating Scales. Clinical variables, including tracheostomy status, radiotherapy, disease stage, chemotherapy, reconstructive surgery, and disease recurrence, were analyzed. Univariate and multivariate analyses were performed to identify factors associated with caregiver burden. Statistical significance was defined as p < 0.05. Results: Caregiver burden was highly prevalent, with a substantial proportion of participants experiencing moderate to severe levels. In the univariate analyses, caregiver burden was significantly higher among caregivers of patients who underwent tracheostomy (p = 0.003), radiotherapy (p < 0.001), chemotherapy (p < 0.001), reconstructive surgery (p = 0.024), and those with advanced-stage disease (p < 0.001). Higher levels of depression and anxiety were significantly associated with increased caregiver burden (both p < 0.001) in the univariate analyses. In the adjusted analysis, anxiety and cohabitation status remained independently associated with caregiver burden, whereas disease stage, tracheostomy, radiotherapy, chemotherapy, reconstructive surgery, disease recurrence, and depression did not retain statistical significance. Educational level, professional caregiving support, and relationship to the patient were also not significantly associated with caregiver burden. Conclusions: Caregiver burden in head and neck cancer is primarily associated with caregiver psychological status and certain social characteristics, while clinical factors play a less prominent role after adjustment. These findings suggest the need for systematic identification of high-risk caregivers based on psychological vulnerability and caregiving demands. Integrating caregiver-focused assessment and targeted psychosocial interventions into multidisciplinary care could improve caregiver well-being and patient-related outcomes.