Prospective Qualitative Multidimensional Assessment of the Postoperative Rhinoplasty Experience

Overview

What the first week after rhinoplasty is actually like has not been measured with a validated instrument. This prospective study surveyed patients at four points in the first eight days, covering pain and six quality of life domains, and tested whether preoperative breathing scores predicted who suffered most.

Sections of note

• Prospective clinical study from June to December 2019 in 60 patients having cosmetic or functional rhinoplasty by two facial plastic surgeons.
• All patients completed the Brief Pain Inventory, a validated pain instrument covering multiple quality of life domains, on postoperative days 1, 2, 3 and 8.
• Preoperative NOSE scores were recorded, along with postoperative EuroQol 5-Dimension scores.
• Primary outcomes were quality of life domains, pain scores, and oxycodone use.
• Quality of life was most disrupted in the first 3 days and essentially returned to normal by day 8, mirroring pain and opioid use.
• All tested domains, general activity, sleep, work, mood, enjoyment and relationships, correlated strongly with overall pain.
• Preoperative NOSE scores were not significantly associated with pain or quality of life impairment.

What it means for a patient

• The difficult period is the first three days, with a return to near normal by about a week.
• Sleep, mood, work and relationships were all affected, and all tracked with how much pain the person had.
• How blocked the nose was before surgery did not predict a harder recovery.
• Limits: 60 patients, two surgeons, one center, and assessment only through day 8.

Why this paper matters

Using a validated general pain instrument allows rhinoplasty recovery to be compared with other operations rather than described in its own terms. The three-day timeline is concrete information for counseling. The study covers only the first week, so the longer recovery is not addressed.

Terms

• Brief Pain Inventory: A validated questionnaire measuring pain and its interference with daily life.
• Quality of life domain: A specific area of life a questionnaire measures, such as sleep or mood.
• NOSE score: The Nasal Obstruction Symptom Evaluation, a validated blockage questionnaire.
• EuroQol 5-Dimension: A general health-related quality of life instrument.
• Postoperative day: Days counted from the day of surgery.