Factors on Quality of Life Improvement in Septorhinoplasty: Prospective Evaluation Using the Functional Rhinoplasty Outcome Inventory 17 and Its Minimally Important Difference

Kuehl GP, Bulut OC, Schuler PJ, Fiedler L, Riedel F, Baumann I, Hohenberger R.

PubMed 42014527 Publisher (DOI)Free full text (PMC)

What this paper says

In 95 functional septorhinoplasty patients followed for 12 months, the strongest predictor of quality-of-life gain was how bad the preoperative score was, and the study set 13.4 points as the smallest FROI-17 change a patient notices.

Overview

The German authors prospectively measured disease-specific quality of life with the FROI-17 before and 12 months after functional septorhinoplasty, and tested which clinical factors (age, sex, approach, deformity type, revision status, body dysmorphic disorder screening) predicted improvement. They also calculated the questionnaire's minimal clinically important difference (MCID) using an internal anchor.

Sections of note

Mean FROI-17 improved from 38.0 (SD 16.0) to 24.5 (SD 20.0), p < 0.001.
Preoperative FROI-17 was the strongest predictor of improvement in both univariate and multivariate analysis (p < 0.001).
Preoperative nasal shape (p = 0.02) and BDD screening result (p = 0.04) were significant in univariate analysis only.
The FROI-17 "self-consciousness" subscale showed high sensitivity and specificity for the BDD screen.
MCID calculated at 13.4 points, matching the cohort's mean improvement. Level of Evidence III.

What it means for a patient

Patients with the worst symptoms before surgery gained the most in this study.
A positive body dysmorphic disorder screen was linked to less improvement.
The average patient improved by about the smallest amount a person can notice, which shows the limits of surgery for some.

Why this paper matters

It gives a usable MCID for a validated functional rhinoplasty questionnaire and shows the tool can flag BDD. Limits: 95 patients, single centre, 12-month follow-up.

Terms

FROI-17: Functional Rhinoplasty Outcome Inventory, a 17-item quality-of-life questionnaire.
Minimal clinically important difference (MCID): the smallest score change a patient would perceive as meaningful.
Body dysmorphic disorder (BDD): preoccupation with a perceived flaw that others see as minor.
Univariate / multivariate analysis: testing one factor at a time versus all together.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: Septorhinoplasty (SRPL) is a frequently performed surgery aimed to improve health-related quality of life (HRQOL), typically assessed using disease-specific questionnaires. This study aimed to analyze the factors influencing postoperative HRQOL improvement and to establish the minimal clinically important difference (MCID) for the Functional Rhinoplasty Outcome Inventory (FROI-17).

Methods: In this prospective study, pre- and twelve months postoperative, disease-specific HRQOL was assessed in 95 patients undergoing functional SRPL (Level of Evidence III). Clinical parameters including age, sex, surgical approach, type of nasal deformity, revision surgery and screening on body dysmorphic disorder were obtained. The primary endpoint was the change in FROI-17 scores. MCID was calculated with an internal anchor.

Results: Mean FROI-17 scores improved from 38.0 ± 16.0 to 24.5 ± 20.0 (p < 0.001). Uni- and multivariate analysis identified the preoperative FROI-17 as the strongest predictor of QoL improvement (p < 0.001). Only the preoperative nasal shape (p = 0.02) and the BDD screening result (p = 0.04) also showed significant correlations in the univariate analysis. The subcategory "self-consciousness" of the FROI-17 showed high sensitivity and specificity for the BDD screening results. An MCID of 13.4 points was calculated, matching the mean postoperative improvement in this cohort.

Conclusions: The preoperative FROI-17 score serves as a reliable predictor of postoperative HRQOL improvement following SRPL. These findings underscore the value of implementing patient-reported outcome measures such as the FROI-17 in preoperative counseling to enhance transparency and long-term patient satisfaction.

Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).