Perceptions and satisfaction of aesthetic outcome following secondary cleft rhinoplasty: evaluation by patients versus health professionals

Abstract

Objective: To explore how improvement in facial appearance is related to patients' perception and satisfaction following cleft rhinoplasty.

Design: A cross-sectional survey.

Participants: 35 cleft rhinoplasty patients treated between 2005 and 2010. 45 observers comprised of healthcare professionals.

Main outcome measures: Evaluation of patient satisfaction including Rhinoplasty Outcome Evaluation (ROE) questionnaire, Preoperative and Postoperative Semi-quantitative Ordinal Scale Rating (PPSOSR) and a specifically designed semi-structured questionnaire. Evaluation by panel of observers using Asher-McDade Aesthetic Index (AMAI) Rating and PPSOSR.

Results: Patient satisfaction was high, based on the ROE questionnaire (score 76.1). 91% of patients rated their appearance as improved, 3% remained 'uncertain' and 6% felt 'different but not improved.' Teenage females (score 94.1) showed statistically higher satisfaction, when compared to older females (score 75.5), or their male counterparts (score 69.8). The preoperative appearance ratings were not statistically different between patients and panel members but postoperatively, patients' rating of their appearance was statistically higher. All components of the AMAI were scored between 'good' to 'fair' (score 9.3). Seventy percent of the panel rated the postoperative appearance as improved. Interestingly, 10% rated the postoperative appearance as 'unchanged', while 3% reported a 'worsened' appearance. There was no correlation between panel assessment of aesthetic outcome and patient satisfaction.

Conclusions: Cleft rhinoplasty contributes to subjective patient satisfaction as a result of their perceived improvement in appearance and function, even though this was not correlated to objective aesthetic rating by panel members.

Keywords: Aesthetic; Cleft-lip nasal deformity; Perception; Rhinoplasty; Satisfaction.