PATIENT REPORTED OUTCOME

MEASURES IN NASAL SURGERY

Irene Pérez, M.D

Otolaryngologist – Facial Plastic Surgeon
Bogotá, Colombia
 Rhinoplasty
Surgical
Outcomes

Aesthetic Functional
 What is available?
• BARONE
– Sistematic review of literature in 2017
– 457 articles  10 elegible
• Objective:
– Find a complete and validated instrument that could be
used in plastic surgery for rhinoplasty patients, that
includes cosmetic and functional aspects, and that has
been developed according to the international
guidelines
– Conclusion: there is no such instrument in the literature

Barone et al, Eur Arch Otorhinolaryngol (2017) 274:1807–1811

• Functional:
– Nasal Surgical Questionnaire (NSQ)
– Nasal Obstruction Symptoms Evaluation Scale (NOSE)
– Nasal Obstruction Septoplasty Effectiveness
• Aesthetic:
– Utrecht Benefit Inventory
– FACEQ*
– Glasgow Benefit Inventory
• Aesthetic and functional:
– Rhinoplasty Outcomes Evaluation (ROE)
– Functional Rhinoplasty Outcome Inventory (FROI-17)
– RHINO Scale
– Evaluation of Aesthetic Rhinoplasty Scale (EARS)
Barone et al, Eur Arch Otorhinolaryngol (2017) 274:1807–1811
 Ching, et al (2003)

Good/Bad
Quality of
Body aesthetic
life
image surgery
measures
outccomes

Eur Arch Otorhinolaryngol (2017) 274:1807–1811

 1. NASAL OBSTRUCTION SYMPTOMS
EVALUATION SCALE
• 2004
• 32 patients, multicentered
• More than 30 nasal obstruction
– Mild: 5-25
– Moderate: 30-50
– Severe: 55-75
– Extreme: 80-100

Stewart et al. Otolaryngology– Head and Neck Surgery. (2004) Volume 130 Number 2
1. NASAL OBSTRUCTION SYMPTOMS
EVALUATION SCALE

Stewart et al. Otolaryngology– Head and Neck Surgery. (2004) Volume 130 Number 2
 Consistent Suceptible
items to change

Groups > Nasal

individuals Obstruction

Stewart et al. Otolaryngology– Head and Neck Surgery. (2004) Volume 130 Number 2
 2. FACE Q
• Ontario, Canada – London 2016
• 5 years recluting patients

JAMA Facial Plast Surg. (2016) January 01

• Developed with 9 patients, field tested in 158
patients
• Nasal module: 3 different questionnaires  19
questions
– Satisfaction with nose (10 questions)
– Adverse effects (4 questions)
– Satisfaction with nostrils (5 questions)
 2. FACE Q

JAMA Facial Plast Surg. (2016) January 01

JAMA Facial Plast Surg. (2016) January 01
Consistent Robust
items methodology

Aesthetic
Long
results
 3. STANDARIZED COSMESIS AND HEALTH
NASAL OUTCOMES SURVEY
• SCHONS Standardized Cosmesis and Health
Nasal
• Outcomes Survey
• 18 patients for development
• Field testing with 191 patients

JAMA Facial Plast Surg. (2017) September 7, 2017.

3. STANDARIZED COSMESIS AND HEALTH
NASAL OUTCOMES SURVEY

JAMA Facial Plast Surg. (2017) September 7, 2017.

Correlation
Consistent
with NOSE
items
Scale

More
Short
studies
 RHINO STUDY
• June 2016 – Jan
Number of Patients by Survey Stage
2017
• 61 patients pre-op
• 51 patients post-op
*Tukey Test p<0.005
 PERFECT PROM

Quantification
Comparison
of positive
of techniques
effects

Identification
of non
candidates
 WHY
Measure surgery results (self-evaluation)

Measure patient satisfaction objectively

Allow comparison with collegues, centers,

countries etc

Research
Thanks! / Gracias
irecami@gmail.com