Clinical Benefits of the Utrecht Questionnaire for Aesthetic Outcome Assessment in Rhinoplasty: An Update.

Presently, there is no consensus on which patient-reported outcome measurement (PROM) instrument is best suited to assess the aesthetic outcomes of rhinoplasty. In this regard, at least seven different validated PROMs are available from the literature, each one with advantages and disadvantages.In this article, we review the development, validation, international translation, and clinical application of the Utrecht Questionnaire (UQ). The UQ was developed in 2009 with the idea to be a short and practical tool for the rhinoplasty surgeon to assess the aesthetic outcomes of rhinoplasty. The questionnaire was then validated in 2013. Body image in relation to nasal appearance is quantified with five simple questions on a 5-point Likert scale and a Visual Analogue Scale score. We discuss how the UQ can easily be incorporated and become an important asset in a rhinoplasty practice. Practical benefits, such as its role in the shared decision-making process, patient expectations management, identification of unsuitable patients, avoiding revision surgery, and the evaluation of the surgeon's personal performance curve, are exemplified. Currently, the UQ has been translated and validated in four languages, providing scientific opportunities to generate and compare international data for advances in rhinoplasty. We describe some of the significant scientific contributions of leaders in the field of rhinoplasty that used the UQ.

Evaluation of vocal changes after vestibular rehabilitation in patients with balance disorders.

BACKGROUND: Although there are articles and studies that associate postural changes with changes in vocal quality, to the best of our knowledge, this was the first study investigating the association between balance disorders and voice. OBJECTIVE: This study aimed to determine whether patients with balance disorders present any clinical, acoustic, or endoscopic vocal changes, and if the correction of balance impairments, such as through vestibular rehabilitation, lead to improvement in vocal quality. METHODS: This was a prospective cohort study that analyzed vocal differences (clinical, videoendostroboscopic, audio-perceptual, and acoustic vocal parameters) in a sample of 43 patients with vestibular dysfunction at three different time points (pre-treatment, post-treatment, and 3 months' post-treatment) diagnosed by videonystagmography with changes in computerized dynamic posturography who were treated with vestibular rehabilitation. RESULTS: In pre-treatment, all of the patients presented supraglottic hyperfunction during videoendoscopic examination and abnormal values in the audio-perceptual scale. After treatment for balance disorders, there was a statistically significant improvement in some parameters of the videoendoscopic and audio-perceptual measures. These improvements were detected immediately after treatment and remained present until at least three months after treatment. CONCLUSIONS: The results suggested that the treatment for balance disorders results in changes in posture and consequently in voice quality.