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Predicting rhinoplasty outcomes

A patient’s preoperative mental health status does not change based on their satisfaction with the functional outcomes of rhinoplasty, according to an Australian study in JAMA Facial Plastic Surgery

The case-control study evaluated baseline nasal function and postsurgical functional outcomes for 88 consecutive rhinoplasty patients at two tertiary rhinologic centers in Sydney. The procedure was performed for both cosmetic and functional goals.

Mean patient age was 37.6 years and 60.2% of patients were women.

All outcomes were assessed preoperatively and six months postoperatively, including nasal function by patient-reported outcome measures and the 36-item Optum SF-36v2 Health Survey mental component summary.

The mental component summary indicated that preoperatively 24 patients had impaired well-being (cases) and 64 patients were normal well-being (controls). Postoperatively, though, mental well-being did not affect change in the nasal function anchor score.

There were also no differences in the fold change of nasal airflow analysis outcomes between the controls and cases.

The study also concluded that rhinoplasty improved patient perceptions of nasal function, with decreased sensation of nasal obstruction, as assessed by a visual analog scale (VAS) on both the left and right side change.

Specifically, 84.4% of patients showed improved scores in the nasal obstruction symptom and 90.40% in the nasal function anchor score.

However, patients with poor mental well-being had a greater improvement in VAS scores for the left side than those who were normal well-being.

In addition, for the Nasal Obstruction Symptom Evaluation Scale (NOSE), case patients improved more than control patients.

The study’s findings “…contrast to anecdotal beliefs that those with worse mental health are less likely to be satisfied or gain benefit from rhinoplasty,” write the authors. However, comparing the current study with other studies in the literature is “…challenging, as there are multiple methods of gauging satisfaction, each with strengths and limitations, that produce different cohorts of satisfied and unsatisfied patients.”

The authors point out that a major hurdle of rhinoplasty is predicting outcomes. The current study provides some evidence that patients perceive improvement in nasal function after surgery, regardless of their mental status.

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