Reporting Outcomes and Outcome Measures in Open Rhinoplasty: A Systematic Review

Hassan Y, Leveille CF, Gallo L, Santos J, Thoma A, McRae MH, McRae MC.

What this paper says

Across 72 open rhinoplasty studies, the authors found 53 different outcomes and 55 different outcome measures in use, of which only three instruments showed adequate validity, reliability and responsiveness.

Overview

Comparative rhinoplasty studies have shown little difference between surgical techniques, and pooling their results is prevented by the fact that everyone measures something different. This systematic review catalogued every outcome and instrument used in the published trials.

Sections of note

Database search of MEDLINE and EMBASE; trials with 20 or more patients aged 18 and over undergoing primary open rhinoplasty were included.
3,235 citations were screened; 72 studies met the inclusion criteria.
53 unique outcomes and 55 postoperative outcome measures were identified.
Outcomes fell into 6 domains: objective signs, subjective symptom severity, physical function related to daily activities, patient satisfaction, surgeon satisfaction, and quality of life.
The 55 measures comprised 5 nasal-specific author-reported instruments, 5 nasal-specific patient-reported instruments, 5 generic patient-reported instruments, and 40 author-generated instruments.
Only the Rhinoplasty Outcomes Evaluation, SNOT-22, and FACE-Q demonstrated adequate validity, reliability and responsiveness to change in rhinoplasty patients.
The authors state a standardized core outcome set is urgently needed.

What it means for a patient

Forty of the 55 instruments were invented by the study authors themselves rather than validated.
With everyone measuring differently, claims that one technique beats another cannot be checked across studies.
Three instruments meet the standard: ROE, SNOT-22 and FACE-Q.
Limits: this appraises the literature rather than patients, and covers only primary open rhinoplasty trials with 20 or more adults.

Why this paper matters

The near-equivalence of published rhinoplasty techniques may reflect measurement chaos rather than genuine equivalence. Documenting 55 measures across 72 studies quantifies that problem. A core outcome set, which the authors call for, does not yet exist.

Terms

Outcome measure: A defined instrument for recording whether a treatment worked.
Core outcome set: An agreed minimum list of outcomes all studies of a condition should report.
Author-generated instrument: A questionnaire invented for one study rather than validated.
Responsiveness: Whether an instrument detects real change over time.
SNOT-22: A 22-item validated questionnaire covering nasal and sinus symptoms.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Comparative studies have shown little statistical difference in outcomes following rhinoplasty, demonstrating near equivalent results across all surgical techniques. Cross-study comparisons of these trials are difficult because variation in outcome reporting prevents statistical pooling and analysis. Objectives: The…”

Excerpt; the full abstract is on PubMed.