Patient-reported outcome measures in external and endonasal functional septorhinoplasty - A propensity score matching study

Abstract

Purpose: Patient satisfaction after functional-aesthetic SRP (faSRP) is highly influenced by the cosmetic result of the surgical procedure. Studies that directly evaluate aesthetic success after external and endonasal faSRP are scarce. The objective of this prospective propensity score matching study was to compare patient-reported satisfaction regarding aesthetic perception following faSRP using the external and endonasal approach in a single-institution single-surgeon survey.

Materials and methods: Out of 161 patients operated by the senior author between October 2011 and March 2017, propensity score matching (PSM) computed 54 patients each following external (group 1) or endonasal faSRP (group 2). Patients reported their satisfaction with the aesthetic appearance of the nose on a visual analogue scale (VAS, 0-10) and five Likert scale questions using the Utrecht questionnaire three and twelve months after surgery.

Results: The mean preoperative VAS score of 3.46 ± 1.06 improved significantly in all patients after faSRP to 4.54 ± 0.38 (F_{(1.69;157.04)} = 634.01, p < 0.001). The VAS increase did not show any correlation to the surgical approach (F(_1;93) = 1.12, p = 0.293). The mean aesthetic sum score (5 = low burden up to 25 = high burden) improved significantly from 13.89 ± 3.78 to 8.46 ± 3.63 after three months (t₍₉₅₎ = 14.021, p < 0.001) and remained almost unchanged after 12 months (8.10 ± 3.76; t₍₉₈₎ = 1.450, p = 0.150) irrespective of the surgical approach (F_{(1,544;143,587)} = 0.126, p = 0.829).

Conclusions: Both the external and endonasal faSRP allowed for significant improvement in patient's aesthetic self-assessment of similar extent.

Keywords: Aesthetic self-assessment; Endonasal septorhinoplasty; External septorhinoplasty; Patient-reported outcome; Quality of life.