Relationship of Sociodemographic Factors and Outcomes in Functional Rhinoplasty

Overview

Whether social and demographic circumstances influence surgical results is studied across medicine but rarely in rhinoplasty. The authors examined one surgeon's patients over nearly six years, comparing short- and longer-term breathing scores and complication rates against six background variables.

Sections of note

• Patients who had functional rhinoplasty, with or without cosmetic work, with the senior author between January 1, 2012, and September 9, 2017, with a preoperative and at least one postoperative NOSE score.
• Variables collected: binary gender, age, marital status, employment status, race, and income based on zip code.
• Primary outcomes were change in NOSE score at short-term follow-up under 3 months and longer-term over 3 months.
• Secondary outcomes were general complications and revision surgery specifically.
• Analysis used descriptive statistics plus univariable linear and logistic regressions.
• 341 patients were included.
• No individual patient-level variable significantly affected short- or longer-term average NOSE change; older age trended toward significance in longer-term change, p 0.07. No factor significantly affected complication or revision rates.

What it means for a patient

• Background circumstances did not predict how much breathing improved in this cohort.
• Complication and revision rates were likewise unrelated to those factors.
• Income was estimated from zip code rather than measured directly, which is an approximation.
• Limits: single surgeon, retrospective, no adjustment for multiple variables together since regressions were univariable, and short-term follow-up defined as under 3 months.

Why this paper matters

Disparities in surgical outcomes are documented across many procedures, and functional rhinoplasty had not been examined. A negative finding in 341 patients is reassuring within one practice. Whether it holds across settings with wider socioeconomic variation is not addressed.

Terms

• Functional rhinoplasty: Nasal surgery aimed at breathing rather than appearance.
• NOSE scale: The Nasal Obstruction Symptom Evaluation, a validated blockage questionnaire.
• Sociodemographic factors: Background characteristics such as age, income, race and employment.
• Univariable regression: Testing one predictor at a time rather than several together.
• Revision surgery: A further operation to correct or improve the result.