Evaluation of Aesthetic and Functional Outcomes After Open Rhinoplasty: A Quasi-experimental Study by the Aid of ROE and RHINO Questionnaires

Overview

Rhinoplasty is performed at a high rate in Iran. The study measured appearance and breathing outcomes using two questionnaires, the Rhinoplasty Outcome Evaluation and the Rhinoplasty Health Inventory and Nasal Outcomes. Patients attending the plastic surgery clinic of the Imam Khomeini hospital complex between 2017 and 2019 who underwent open rhinoplasty completed both questionnaires before surgery and again six months afterward.

Sections of note

• Prospective quasi experimental study; the journal assigns level of evidence IV.
• Both questionnaires were completed before surgery and at 6 months.
• ROE score rose from 51.27 plus or minus 10.54 to 79.6 plus or minus 9.67, P less than 0.001.
• RHINO score rose from 64.13 plus or minus 11.43 to 83.36 plus or minus 11.03, P less than 0.001.
• Outcomes were examined across age groups, genders and educational levels.
• The commonest reasons for satisfaction were the nose feeling more natural, 62 percent of patients, and good tip rotation, 32 percent.
• The commonest reasons for dissatisfaction were the nose being too wide, 25 percent, and a bulbous tip, 25 percent.

What it means for a patient

• Scores improved substantially on both scales, so most patients rated the result better than their starting point.
• A quarter of patients still named the nose too wide, and a quarter named a rounded tip, as complaints after surgery.
• There was no control group and no comparison of surgical techniques, so the improvement cannot be attributed to any particular method.
• Follow up was six months, which is short for a nose that continues to change with healing.

Why this paper matters

Patient reported outcome measures are now the standard way to judge rhinoplasty, and this study applies two of them in a high volume national setting. It quantifies both the improvement and the residual complaints. The abstract does not state the number of patients, which limits how much weight the figures carry.

Terms

• Open rhinoplasty: surgery through a small incision across the columella, lifting the skin for direct view.
• ROE: Rhinoplasty Outcome Evaluation, a short questionnaire on satisfaction with the nose.
• RHINO: Rhinoplasty Health Inventory and Nasal Outcomes, covering appearance and breathing.
• Quasi experimental: a before and after study without random assignment or a control group.
• Bulbous tip: a wide, rounded nasal tip.