Generic Health-Related Quality-of-Life Changes after Rhinoplasty: A Prospective Study with Long-Term Results

Rui Xavier; Sofia Azeredo-Lopes; Dirk-Jan Menger; Henrique Cyrne de Carvalho; Jorge Spratley

doi:10.1055/a-1932-8563

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2023; 39(02): 164-172
DOI: 10.1055/a-1932-8563

Original Research

Generic Health-Related Quality-of-Life Changes after Rhinoplasty: A Prospective Study with Long-Term Results

Rui Xavier

¹Department of Otolaryngology, Hospital Luz Arrabida, Porto, Portugal

,

Sofia Azeredo-Lopes

²CHRC, NOVA Medical School | Faculdade de Ciências Médicas, NMS|FCM, Universidade Nova de Lisboa, Lisboa, Portugal

³Department of Statistics and Operational Research, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal

,

Dirk-Jan Menger

⁴University of Utrecht, Utrecht, The Netherlands

,

Henrique Cyrne de Carvalho

⁵Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal

,

Jorge Spratley

⁶Faculdade de Medicina da Universidade do Porto, Centro Hospitalar e Universitário S. João and Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Porto, Portugal

› Author Affiliations

Abstract

Objectives Our objective was to investigate changes in specific generic health-related quality-of-life (HRQoL) domains achieved by rhinoplasty, to investigate whether modifications of somatic-, psychologic-, and social-related HRQoL domains are different in patients with functional or aesthetic motivation for rhinoplasty, and to investigate if HRQoL changes are related to a functional or an aesthetic nasal improvement.

Study Design This was a prospective study with 1 year of follow-up.

Methods Fifty-four consecutive Caucasian patients submitted to rhinoplasty were evaluated with 36-item Short Form Health Survey (SF-36) and EuroQuality-of-Life 5 Domain (EQ-5D) questionnaires. To correlate changes in generic HRQoL with functional and aesthetic modifications achieved by rhinoplasty, evaluation of patients also included assessment of Peak Nasal Inspiratory Flow and Nasal Obstruction Symptom Evaluation, Visual Analogue Scale for nasal airway obstruction (NAO), and Rhinoplasty Outcome Evaluation scores.

Modifications in each generic HRQoL health-domain were analyzed to investigate the possible relation with motivation for surgery and with functional or aesthetic improvement.

Results There was a significant improvement in EQ-5D (p < 0.001), EQ-5D VAS (p = 0.002) and in the SF-36 domains of general health (p < 0.001), energy (p < 0.001), physical functioning (p < 0.001), physical limitation (p = 0.005), pain (p = 0.003), and well-being (p = 0.018). Improvement was significant in groups of patients with NAO or in whom a septoplasty was performed and was associated with patient-reported functional improvement. There was a significant improvement in health change (p < 0.001), verified in all groups of patients.

Conclusions This prospective study with long-term results demonstrates that rhinoplasty significantly improves most domains of generic HRQoL. This improvement is associated with patient-reported functional improvement. Emotional limitation and social functioning are not significantly changed by rhinoplasty.

Level of Evidence: IV.

Keywords

rhinoplasty - outcomes - HRQoL - EQ-5D - SF-36

Full Text

References

References
1 Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30 (06) 473-483
2 EuroQol Group. EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (03) 199-208
3 Steward A, Sherbourne C, Hayes R. et al. Summary and discussion of MOS measures. In: Measuring Functioning and Well-Being: The Medical Outcome Study Approach, 345–371. A.L. Stewart & J.E. Ware (eds.), Durham, NC: Duke University Press; 1992
4 Ferreira PL. Criação da versão portuguesa do MOS SF-36. Parte I–Adaptação cultural e linguística. Acta Med Port 2000; 13 (1-2): 55-66
5 Ferreira PL. Criação da versão Portuguesa do MOS SF-36. Parte II–Testes de validação. Acta Med Port 2000; 13 (03) 119-127
6 Ferreira PL, Ferreira LN, Pereira LN. Contributos para a Validação da Versão Portuguesa do EQ-5D. Acta Med Port 2013; 26 (06) 664-675
7 Bezerra TF, Padua FG, Pilan RR, Stewart MG, Voegels RL. Cross-cultural adaptation and validation of a quality of life questionnaire: the Nasal Obstruction Symptom Evaluation questionnaire. Rhinology 2011; 49 (02) 227-231
8 Esteves S, Silva A, Ferreira M. et al. Validação do questionário rhinoplasty outcome evaluation (ROE) para português. Rev Port Otorrinolaringol Cir Cer-Fac 2015; 53: 81-85
9 R Core Team R. A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria 2020. https://www.R-project.org/
10 Bates D, Maechler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw 2015; 67: 1-48
11 Fuller JC, Levesque PA, Lindsay RW. Assessment of the EuroQol 5-Dimension Questionnaire for detection of clinically significant global health-related quality-of-life improvement following functional septorhinoplasty. JAMA Facial Plast Surg 2017; 19 (02) 95-100
12 Yamasaki A, Levesque PA, Bleier BS. et al. Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery. Laryngoscope 2019; 129 (07) 1554-1560
13 Lavinsky-Wolff M, Camargo Jr HL, Barone CR. et al. Effect of turbinate surgery in rhinoseptoplasty on quality-of-life and acoustic rhinometry outcomes: a randomized clinical trial. Laryngoscope 2013; 123 (01) 82-89
14 de Moura BH, Migliavacca RO, Lima RK. et al. Partial inferior turbinectomy in rhinoseptoplasty has no effect in quality-of-life outcomes: a randomized clinical trial. Laryngoscope 2018; 128 (01) 57-63
15 Stewart EJ, Robinson K, Wilson JA. Assessment of patient's benefit from rhinoplasty. Rhinology 1996; 34 (01) 57-59
16 Papadopulos NA, Liebmann J, Kloeppel M. et al. Quality of life after rhinoplasty: a prospective study. Facial Plast Surg 2021; 37 (05) 639-645
17 Niehaus R, Kovacs L, Machens HG, Herschbach P, Papadopulos NA. Quality of life-changes after rhinoplasty. Facial Plast Surg 2017; 33 (05) 530-536
18 Kotzampasakis D, Piniara A, Themelis S. et al. Quality of life of patients who underwent aesthetic rhinoplasty: 100 cases assessed with the Glascow Benefit Inventory. Laryngoscope 2017; 127 (09) 2017-2025
19 Zojaji R, Keshavarzmanesh M, Arshadi HR, Mazloum Farsi Baf M, Esmaeelzadeh S. Quality of life in patients who underwent rhinoplasty. Facial Plast Surg 2014; 30 (05) 593-596
20 Bulut OC, Wallner F, Oladokun D. et al. Long-term quality of life changes after primary septorhinoplasty. Qual Life Res 2018; 27 (04) 987-991