Systematic Review of Quality-of-Life Measurement After Aesthetic Rhinoplasty

Overview

Success in cosmetic rhinoplasty is judged mainly by patient satisfaction and quality of life, but the instruments used to measure those vary widely, making studies hard to compare. This systematic review searched three databases to map what has been used and what the better studies show.

Sections of note

• Searches used PubMed/MEDLINE, Google Scholar and Cochrane, with the terms rhinoplasty and quality of life, covering 2002 to 2017.
• Secondary selection required a prospective design, at least 50 patients, and at least 6 months of follow-up.
• 62 patient-reported outcome measure studies were identified; the publication rate increased over the 15 years.
• Only 17 studies satisfied the comprehensive inclusion criteria.
• The Rhinoplasty Outcome Evaluation was the most frequently used questionnaire in that selection, at 70.6 percent.
• A total of 16 different questionnaires were in use, described as high heterogeneity.
• The authors conclude that functional-aesthetic rhinoplasty leads to significant improvement in health-related quality of life, despite a lack of reliable publications and large variability in outcomes. Level of evidence II.

What it means for a patient

• Quality of life improves after rhinoplasty across the studies reviewed, but the evidence base is inconsistent.
• Fewer than one in three of the studies found met basic quality criteria of design, size and follow-up.
• Sixteen different questionnaires means results from different surgeons often cannot be compared directly.
• Limits: this reviews existing studies rather than measuring patients, and does not pool the results numerically.

Why this paper matters

Measurement inconsistency is the central obstacle to comparing rhinoplasty outcomes between surgeons and techniques. This documents its scale and identifies the most used instrument. It does not produce a pooled effect size or recommend a single standard.

Terms

• Quality of life: How much a condition or treatment affects daily functioning and wellbeing.
• Patient-reported outcome measure: A questionnaire a patient completes about their own condition.
• Systematic review: A structured search and appraisal of all studies on a question.
• Heterogeneity: The degree to which studies differ from each other in method or result.
• Rhinoplasty Outcome Evaluation: A validated questionnaire scoring satisfaction with the nose.