Clinical Benefits of the Utrecht Questionnaire for Aesthetic Outcome Assessment in Rhinoplasty: An Update

Overview

The authors state there is no consensus on which patient reported instrument is best for assessing appearance outcomes in rhinoplasty, with at least seven validated options available, each with advantages and drawbacks. This article reviews the development, validation, translation and clinical use of one of them, the Utrecht Questionnaire.

Sections of note

• Review article; the abstract reports no patient numbers, no outcomes and no follow up of its own.
• The questionnaire was developed in 2009 as a short practical tool and validated in 2013.
• It quantifies body image in relation to nasal appearance with five questions on a five point scale plus a visual analogue score.
• The article discusses how it can be incorporated into a rhinoplasty practice.
• Stated practical benefits include a role in shared decision making and in managing patient expectations.
• Further stated benefits are identifying unsuitable patients, avoiding revision surgery and evaluating a surgeon's own performance over time.
• It has been translated and validated in four languages, allowing international comparison.
• The article describes scientific contributions by figures in the field who used the instrument.

What it means for a patient

• The questionnaire is short, which is the practical reason it is used in routine consultation.
• It measures how the patient feels about their nose rather than how the surgeon judges the result.
• Claims that it helps identify unsuitable patients or avoid revision surgery are stated as benefits, not demonstrated with data here.
• The proliferation of at least seven validated instruments means results across studies are often not directly comparable.

Why this paper matters

Outcome research in rhinoplasty depends on questionnaires, and the field has not agreed which to use. This article makes the case for one of the shorter options. Whether using it changes practice or reduces revisions has not been measured.

Terms

• Patient reported outcome measure: a questionnaire completed by the patient rather than the clinician.
• Utrecht Questionnaire: a five item instrument on satisfaction with nasal appearance.
• Validation: formal testing that an instrument measures what it claims to.
• Likert scale: an ordered rating scale, here with five points.
• Shared decision making: the patient and clinician choosing a plan together.