Postoperative Functional and Cosmetic Satisfaction among Subjects Undergoing Open Versus Endonasal Septorhinoplasty: Five Years' Experience from an Open-label Study at a Tertiary Care Center in Oman

Crooked Nose: Aesthetic and Functional Outcomes

Purpose

To highlight a detailed analysis of aesthetic and functional rhinoplasty outcomes utilizing the most recent highly validated Standardized Cosmesis Health Nasal Outcomes Survey (SCHNOS) for Middle Eastern crooked nose patients.

Methods

A longitudinal cohort study scrutinizing preoperative rhinoplasty patients' satisfaction retrospectively and their postoperative outcomes prospectively. The patients fulfilled the Arabic SCHNOS during postoperative follow-up. Preoperative and postoperative responses were recorded and then reviewed and analyzed.

Results

This study included 41 patients with a mean age of 27.8 years. Females represented 41.5% of patients. About 73% of patients had a history of trauma. 90% of patients underwent primary procedures for crooked nose correction. Twelve patients (29.3%) underwent surgery for functional reasons, and twenty-six (63.4%) had it for both aesthetic and functional issues. There was a statistically significant difference regarding changes in SCHNOS regarding nasal obstruction scores (SCHNOS-O) and nasal cosmesis scores (SCHNOS-C) (p < 0.001). These findings coincided with a substantial reduction of all SCHNOS items postoperatively (p < 0.001). There was no statistically significant relationship between changes in (SCHNOS-O) or (SCHNOS-C) pre-and postoperatively and either age, sex, history of trauma, or type of surgery. However, a statistically significant difference was detected when assessing the relationship between changes in SCHNOS-O and the reason for surgery.

Conclusion

A thorough knowledge of three-dimensional pathology and time-associated changes is required to achieve optimal aesthetic and functional outcomes for crooked nose patients. The use of highly validated questionnaires like SCHNOS in clinical practice is highly encouraged to modify and trace surgical techniques to the most appropriate and successful ones for the patients.

The Need for Innovation in Rhinoplasty

Rhinoplasty is a challenging surgery and results are not always perfect. There are many obstacles to achieving optimal results. Among these are inadequate instrumentation, the unpredictability of healing, imprecise planning, and many more. Furthermore, selecting patients who can most benefit from surgery is equally important. In this article, some of the more pressing areas of rhinoplasty that need innovation are discussed. From proper patient selection, to advances in education, to the standardization of training programs, to the development of sophisticated implants, the future of rhinoplasty surgery lies in continued creativity and innovation.

The Effect on Patient Satisfaction of the Postoperative Nasal Topographic, Demographic, and Functional Results of Open and Closed Septorhinoplasty Techniques

AIM

To evaluate the contribution to patient satisfaction of the newly reshaped topographic anatomy of the nose, demographic, and functional results in the postoperative period of septorhinoplasty surgery.

METHOD

A total of 370 patients applied with open and closed septorhinoplasty techniques for various reasons were grouped according to the postoperative Rhinoplasty Outcome Evaluation (ROE) Scale results; Group 1 (open rhinoplasty satisfied group, ROE ≥12 points, n:194), Group 2 (open rhinoplasty dissatisfied group, ROE <12 points, n:23), Group 3 (closed rhinoplasty satisfied group, ROE ≥12 points, n:137), Group 4 (closed rhinoplasty dissatisfied group, ROE <12 points, n:16). The groups were evaluated in respect of the effect on patient satisfaction of functional and demographic variables and satisfaction with the topographic outcome of the nose.

RESULTS

The effect of the topographic surgical results was evaluated on patient satisfaction. A correlation was determined between nasal topographic satisfaction and patient satisfaction (r:0.228, P = 0.009). In the subgroup analyses, the only factor among the topographic factors which had an effect on satisfaction was the nasal tip (r:0.187, P = 0.024). Although 30.7% (n:39) of patients dissatisfied with the surgery reported that they were not satisfied with the nasal base results, no correlation was determined between nasal base and satisfaction (r:0.091, P = 0.463). The strongest correlations of patient satisfaction were determined to be with subjective (NOSE score [r:0.530, P < 0.001]) and objective (high nasal resistance levels [r:0.579, P < 0.001]) functional results.

CONCLUSION

The 2 basic components of postoperative satisfaction with SRP surgery were shown to be functional healing and cosmetic outcomes. Of the surgical topographic results, nasal tip and nasal base were the parts determined to require the most attention.