Disparities in NOSE Scores and Surgical Approaches among Patients Undergoing Functional Rhinoplasty

Area of Science:

• Otolaryngology
• Health Services Research
• Socioeconomic Determinants of Health

Background:

• Social determinants of health (SDOH) are crucial in medicine but understudied in functional rhinoplasty.
• Functional rhinoplasty aims to improve nasal airflow and breathing, impacting quality of life.

Purpose of the Study:

• To evaluate the association between insurance type (a proxy for socioeconomic status) and outcomes in functional rhinoplasty.
• To identify potential disparities in care related to social determinants of health.

Main Methods:

• Retrospective review of 116 patients undergoing functional rhinoplasty between 2013-2016.
• Nasal Obstruction Symptom Evaluation (NOSE) scores used for pre- and post-operative symptom assessment.
• Analysis of demographic data, surgical techniques, and insurance type (public vs. private, including Medicaid).

Main Results:

• Medicaid patients trended towards greater improvement in NOSE scores (56.39 vs. 47.90) compared to non-Medicaid patients, though not statistically significant (p=0.067).
• No significant differences in pre-operative NOSE scores or overall improvement were found between insurance groups.
• Medicaid patients were more likely to have a history of nasal trauma and prior surgeries.

Conclusions:

• While trends suggest potential benefits for Medicaid patients, functional rhinoplasty outcomes did not significantly differ by insurance type in this cohort.
• Further research is needed to explore SDOH, socioeconomic status, and potential biases affecting care delivery and outcomes in functional rhinoplasty.
• Understanding these associations can improve healthcare delivery and patient results.