Influence of age on rhinoplasty outcomes evaluation: a preliminary study.

BACKGROUND: The aim of this study was to evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and determine the influence of patient age on the outcomes. METHODS: We conducted a longitudinal study to assess patients' pre- and postoperative degrees of satisfaction with their results. The study was done at a tertiary-care medical center. The ROE questionnaire was applied twice in the same visit and aimed at measuring the patient's satisfaction in both pre- and postoperative moments. RESULTS: The initial sample of this study was composed of 112 patients, 61 of whom have answered the ROE questionnaire. A mean difference of 50.5 (P < 0.0001) was observed between the pre- and postoperative satisfaction scores. No statistically significant difference was observed on the mean difference between pre- and postoperative satisfaction scores (CHANGE) according to sex (P = 0.673), the follow-up time period (P = 0.629), or the kind of surgical procedure (P = 0.904). The mean postoperative score of the <30-year-old group was lower than the mean of 30 to <50-year-old (P < 0.003) and ≥50-year-old groups (P < 0.009). CONCLUSION: The ROE questionnaire is a tool for evaluating the outcomes of different surgical indications for correcting nasal deformities. The kind of surgical procedure had no influence on the mean difference between pre- and postoperative satisfaction scores. By using this tool we found that the younger age group reported lower postoperative satisfaction scores than older patients.

Assessment of symptom improvement following nasal septoplasty with or without turbinectomy.

UNLABELLED: Most studies show that objective measures to quantify and determine surgical success in the treatment of nasal obstruction do not correlate with subjective improvement as reported by patients. AIM: To evaluate the subjective improvement of nasal symptoms in patients undergoing septoplasty with or without turbinectomy. MATERIALS AND METHODS: A prospective study. We evaluated 72 septoplasty patients with or without partial inferior turbinectomy; the patients answered a questionnaire preoperatively and on the 60th day after surgery. RESULTS: Septoplasty was done associated with bilateral partial inferior turbinectomy in 83.3% of patients; it was unilateral in 9.7%; there was no need for turbinate reduction in 6.9%. An improvement of all symptoms was observed after surgery. Nasal obstruction had improved in 68 patients (94.4%) by the 60th postoperative day. The average nasal obstruction score in patients with and without allergic symptoms was similar before surgery and on the 60th postoperative day. Older patients had milder preoperative allergic symptoms. CONCLUSIONS: Nasal symptoms in patients undergoing septoplasty, with or without turbinectomy, improved. Patients with and without allergic symptoms showed a similar improvement of nasal obstruction on the 60th postoperative day.

Assessment of symptom improvement following nasal septoplasty with or without turbinectomy / Avaliação da melhora dos sintomas nasais após septoplastia com ou sem turbinectomia

Most studies show that objective measures to quantify and determine surgical success in the treatment of nasal obstruction do not correlate with subjective improvement as reported by patients. AIM: To evaluate the subjective improvement of nasal symptoms in patients undergoing septoplasty with or without turbinectomy. MATERIALS AND METHODS: A prospective study. We evaluated 72 septoplasty patients with or without partial inferior turbinectomy; the patients answered a questionnaire preoperatively and on the 60th day after surgery. RESULTS: Septoplasty was done associated with bilateral partial inferior turbinectomy in 83.3 percent of patients; it was unilateral in 9.7 percent; there was no need for turbinate reduction in 6.9 percent. An improvement of all symptoms was observed after surgery. Nasal obstruction had improved in 68 patients (94.4 percent) by the 60th postoperative day. The average nasal obstruction score in patients with and without allergic symptoms was similar before surgery and on the 60th postoperative day. Older patients had milder preoperative allergic symptoms. CONCLUSIONS: Nasal symptoms in patients undergoing septoplasty, with or without turbinectomy, improved. Patients with and without allergic symptoms showed a similar improvement of nasal obstruction on the 60th postoperative day.

A maioria dos estudos mostra que medidas objetivas para quantificar e determinar o sucesso das cirurgias para a obstrução nasal não têm correlação com a melhora subjetiva relatada pelo paciente. OBJETIVO: Avaliar a melhora dos sintomas nasais nos pacientes submetidos à septoplastia, com ou sem turbinectomia. MATERIAL E MÉTODO: Estudo prospectivo. Foram avaliados 72 pacientes submetidos à septoplastia, com ou sem turbinectomia inferior parcial, que responderam ao questionário no préoperatório até o 60º dia de pós-operatório (PO). RESULTADOS: Foi realizada septoplastia associada à turbinectomia inferior parcial bilateral em 83,3 por cento dos pacientes, unilateral em 9,7 por cento e não houve necessidade de redução das conchas nasais em 6,9 por cento. Foi observada melhora para todos os sintomas no pós-operatório. Sessenta e oito (94,4 por cento) pacientes apresentaram melhora da obstrução nasal no 60º PO. A média da nota da obstrução nasal entre os pacientes com e sem sintomas alérgicos foi semelhante no pré-operatório e no 60º PO. Os pacientes mais velhos apresentaram menor intensidade dos sintomas alérgicos no pré-operatório. CONCLUSÕES: Os pacientes submetidos à septoplastia, com ou sem turbinectomia, evoluem com melhora de todos os sintomas nasais. Os pacientes com e sem sintomas alérgicos apresentam melhora da obstrução nasal de forma semelhante no 60º PO.

Crooked nose: outcome evaluations in rhinoplasty.

UNLABELLED: A crooked nose is the result of deformities that might involve the bony nasal pyramid, the upper and lower lateral cartilages, and nasal septum, causing complaints of aesthetic and/or functional nature. PURPOSE: To evaluate how satisfied are those patients who underwent rhinoplasty to correct crooked nose, through the questionnaire Rhinoplasty Outcomes Evaluation (ROE). MATERIAL AND METHOD: A longitudinal study with retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent rhinoplasty. ROE questionnaire was applied twice in the same visit aiming at measuring patient satisfaction in both pre and postoperative periods. Nineteen patients who underwent rhinoplasty answered the ROE. RESULTS: For all patients who underwent rhinoplasty, the average preoperative satisfaction score was of 24. 6 ± 11. 3, while the average postoperative score was of 76. 1 ± 19. 5 (p<0. 0001). Average differences between pre and postoperative satisfaction scores in patients younger than 30 years of age were lower than those reported by >30-year-old patients (p = 0. 05). CONCLUSIONS: From the Rhinoplasty Outcomes Evaluation questionnaire, it is possible to demonstrate the impact that rhinoplasty to correct a crooked nose determines the quality of life of patients. Approximately 90% of patients undergoing rhinoplasty believed they achieved a good or excellent postoperative result.

Crooked nose: outcome evaluations in rhinoplasty / Nariz torto: avaliação de resultados em rinoplastia

A crooked nose is the result of deformities that might involve the bony nasal pyramid, the upper and lower lateral cartilages, and nasal septum, causing complaints of aesthetic and/or functional nature. PURPOSE: To evaluate how satisfied are those patients who underwent rhinoplasty to correct crooked nose, through the questionnaire Rhinoplasty Outcomes Evaluation (ROE). MATERIAL AND METHOD: A longitudinal study with retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent rhinoplasty. ROE questionnaire was applied twice in the same visit aiming at measuring patient satisfaction in both pre and postoperative periods. Nineteen patients who underwent rhinoplasty answered the ROE. RESULTS: For all patients who underwent rhinoplasty, the average preoperative satisfaction score was of 24. 6±11. 3, while the average postoperative score was of 76. 1±19. 5 (p<0. 0001). Average differences between pre and postoperative satisfaction scores in patients younger than 30 years of age were lower than those reported by >30-year-old patients (p=0. 05). CONCLUSIONS: From the Rhinoplasty Outcomes Evaluation questionnaire, it is possible to demonstrate the impact that rhinoplasty to correct a crooked nose determines the quality of life of patients. Approximately 90 percent of patients undergoing rhinoplasty believed they achieved a good or excellent postoperative result.

O nariz torto ou laterorrinia é resultado de deformidades que podem envolver a pirâmide nasal, as cartilagens laterais superiores, alares e o septo nasal, causando queixas estéticas e/ou funcionais. OBJETIVO: Avaliar a satisfação dos pacientes submetidos à rinoplastia para a correção do nariz torto, a partir do questionário Rhinoplasty Outcomes Evaluation (ROE). MATERIAL E MÉTODO: Estudo longitudinal, tipo coorte retrospectivo, com análise retrospectiva da satisfação pré-operatória e prospectiva da satisfação pós-operatória. Dezenove pacientes submetidos à rinoplastia responderam ao questionário ROE. RESULTADOS: A média da nota da satisfação de todos os pacientes submetidos à rinoplastia, para a correção do nariz torto, no pré-operatório foi de 24,6±11,3 e no pós-operatório foi de 76,1±19,5 (p<0,0001). Os pacientes com idade <30 anos apresentaram menor média da diferença das notas da satisfação entre pós e pré-operatório que os pacientes >30 anos (p=0,05). CONCLUSÃO: A partir da aplicação do questionário Rhinoplasty Outcomes Evaluation, é possível demonstrar o impacto que a rinoplastia para a correção do nariz torto determina na qualidade de vida dos pacientes. Aproximadamente 90 por cento dos pacientes submetidos à rinoplastia para a correção do nariz torto consideram que atingiram bom ou excelente resultado pós-operatório.

Avaliação da necessidade do uso do tampão nasal após septoplastia com turbinectomia / Evaluation about the requirement to use a pack after septoplasty with turbinectomy

Introdução: A septoplastia associada a turbinectomia inferior parcial é uma das cirurgias mais realizada no pacientes com obstrução nasal. O tampão nasal tem sido usado para controle primário do sangramento nestas cirurgias. Várias complicações têm sido relacionadas com o uso do tampão nasal, alem de causarem dor e desconforto importante com seu uso. Alguns estudos têm questionado a eficácia do tampão nasal no controle do sangramento e das complicações após septoplastia e turbinectomia. Objetivo: Comparar o grau de sangramento nasal entre os pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral que usaram ou não tampão nasal. Método: Foi realizado estudo prospectivo no qual foram avaliados 60 pacientes com diagnóstico de desvio do septo nasal com hipertrofia das conchas inferiores. Os pacientes foram submetidos à septoplastia com turbinectomia bilateral com visualização direta. Foram divididos em 2 grupos: sem tampão e com tampão (Merocel® e dedo de luva). Estes foram avaliados no pós-operatório, a partir da avaliação da intensidade do sangramento. Resultado: Foi observado que o grau de sangramento no pós-operatório no grupo submetido à turbinectomia inferior parcial bilateral e que usou tampão nasal foi menor, do que no grupo que não usou tampão. Conclusão: Pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral e não usaram tampão nasal no pós-operatório apresentaram mais sangramento do que os pacientes que usaram tampão nasal.

Introduction: Septoplasty associated with a partial inferior turbinectomy is one of the most frequent surgeries performed in patients with nasal obstruction. The nasal pack has been used to control primary bleeding in these surgeries. Several complications have been related to the nasal pack, besides causing pain and a relevant discomfort. Some studies have investigated both the efficiency of the nasal pack to control bleeding and the complications after septoplasty and turbinectomy. Objective: To compare the degree of nasal bleeding among patients submitted to septoplasty with partial bilateral inferior turbinectomy, whether using the nasal pack or not. Method:An outlook study was performed to evaluate 60 patients diagnosed of a deviated nasal septum with an inferior concha hypertrophy. The patients were submitted to bilateral turbinectomy septoplasty under direct visualization. They were divided into 2 groups: without pack and with pack (Merocel* and protective sheath). These were evaluated after surgery, based on the evaluation of bleeding intensity. Result: It was observed that the post-surgical bleeding degree of the group submitted to partial bilateral inferior turbinectomy, who used the nasal pack, was lower than the group not using a pack. Conclusion: Patients submitted to septoplasty with partial bilateral inferior turbinectomy, not using a post-surgical nasal pack, appeared to bleed more than patients using a nasal pack.

Avaliação de resultados em rinoplastia de redução / Results evaluation in reduction rhinoplasty

Introduction: final results evaluation after rhinoplasty is a not a topic widely studied from the patient's viewpoint. Objective: evaluate the satisfaction of the patients submitted to reduction rhinoplasty, from the questionnaire Rhinoplasty Outcomes Evaluation (ROE). Method: longitudinal study, retrospective cut type, of the preoperative and postoperative satsfaction. The sample was composed by 28 patients who were submitted to rhinoplasty and answered the ROE questionnaire. Three variables were obtained: satisfaction note that the patient had with his/her image before the surgery; note of satisfaction with the current appearance; the difference of the average satisfaction notes between postoperative and preoperative approaches. Results: the postoperative note was higher than the preoperative in all patients. We noticed a difference between the average of the postoperative and preoperative of 48,3 (p<0,0001). In the preoperative approach we notice that 100% of the patients had satisfaction of <50. In the postoperative there was a 92,9% migration from classification <50 to classes: 50 to <75 considered to be good (25%); > or =75 considered to be an excellent outcome (67,9%). Conclusions: the ROE questionnaire is a helpful tool to show the satisfaction of the patient submitted to reduction rhinoplasty. About 92% of the patients submitted to reduction rhinoplasty consider the postoperative result to be good or excellent (AU)

Avaliação de resultados em rinoplastia de redução / Results evaluation in reduction rhinoplasty

Introdução: A avaliação do resultado final após rinoplastia é um tema pouco estudado pela visão do paciente. Objetivo: Avaliar a satisfação dos pacientes submetidos à rinoplastia de redução, a partir do questionário Rhinoplasty Outcomes Evaluation (ROE). Método: Estudo longitudinal, tipo coorte retrospectivo, da satisfação pré-operatória e pós-operatória. A amostra foi composta por 28 pacientes submetidos à rinoplastia que responderam ao questionário ROE. Foram obtidas três variáveis: nota da satisfação que o paciente tinha com sua imagem antes da cirurgia; nota da satisfação com a atual aparência; e a diferença das médias das notas da satisfação entre pós e pré-operatório. Resultados: A nota pós-operatória foi superior a pré-operatória em todos os pacientes. Foi observada diferença entre as médias das notas do pós e pré-operatório de 48,3 (p<0,0001). No pré-operatório foi observado que 100% dos pacientes apresentaram satisfação <50. No pós-operatório foi observado que 92,9% migraram da classe <50 para as classes: 50 a <75 considerado bom (25%); >75 considerado excelente resultado (67,9%). Conclusão: O questionário ROE é uma ferramenta útil em demonstrar a satisfação do paciente submetido à rinoplastia de redução. Cerca de 92% dos pacientes submetidos à rinoplastia de redução consideram bom ou excelente resultado no pós-operatório.

Introduction: Final results evaluation after rhinoplasty is a not a topic widely studied from the patient's viewpoint. Objective: Evaluate the satisfaction of the patients submitted to reduction rhinoplasty, from the questionnaire Rhinoplasty Outcomes Evaluation (ROE). Method: Longitudinal study, retrospective cut type, of the preoperative and postoperative satisfaction. The sample was composed by 28 patients who were submitted to rhinoplasty and answered the ROE questionnaire. Three variables were obtained: satisfaction note that the patient had with his/her image before the surgery; note of satisfaction with the current appearance; the difference of the average satisfaction notes between postoperative and preoperative approaches. Results: The postoperative note was higher than the preoperative in all patients. We noticed a difference between the average of the postoperative and preoperative of 48.3 (p<0.0001). In the preoperative approach we noticed that 100% of the patients had satisfaction of <50. In the postoperative there was a 92.9% migration from classification <50 to classes: 50 to <75 considered to be good (25%); >75 considered to be an excellent outcome (67.9%). Conclusions: The ROE questionnaire is a helpful tool to show the satisfaction of the patient submitted to reduction rhinoplasty. About 92% of the patients submitted to reduction rhinoplasty consider the postoperative result to be good or excellent.

Avaliação da necessidade do uso do tampão nasal após septoplastia com turbinectomia / Assessment of need for the use of nasal packing after septoplasty with turbinectomy

Introdução: a septoplastia associada a turbinectomia inferior parcial é uma das cirurgias mais realizadas nos pacientes com obstrução nasal. O tampão nasal tem sido usado para controle primário do sangramento nestas cirurgias. Várias complicações têm sido relacionadas com o uso do tampão nasal, além de causarem dor e desconforto importante com seu uso. Alguns estudos têm questionado a eficácia do tampão nasal no controle do sangramento e das complicações após septoplastia e turbinectomia. Objetivo: comparar o grau de sangramento nasal entre os pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral que usaram ou não tampão nasal. Método: foi realizado estudo prospectivo no qual foram avaliados 60 pacientes com diagnóstico de desvio do septo nasal com hipertrofia das conchas inferiores. Os pacientes foram submetidos à septoplastia com turbinectomia bilateral com visualização direta. Foram divididos em 2 grupos: sem tampão e com tampão [Merocel (R) e dedo de luva] . Estes foram avaliados no pós-operatório, a partir da avaliação da intensidade do sangramento. Resultado: foi observado que o grau de sangramento no pós-operatório no grupo submetido à turbinectomia inferior parcial bilateral e que usou tampão nasal foi menor, do que no grupo que não usou tampão. Conclusão: pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral e não usaram tampão nasal no pós-operatório apresentaram mais sangramento do que os pacientes que usaram tampão nasal (AU)