Assessment of patient's benefit from rhinoplasty

It is standard practice for most rhinoplasty surgeons to assess what they perceive to be the cosmetic outcome of their surgery. There have, however, been few attempts to gauge the degree of success of rhinoplasty from the patient's perspective. The aim of this study was to measure the benefit of rhinoplasty in an unselected group of patients who had undergone this procedure under the National Health Service (NHS). Two hundred and twenty-four patients who had undergone rhinoplasty or septorhinoplasty in the Department of Otolaryngology at Glasgow Royal Infirmary from 1990 to 1994 were surveyed by post; two questionnaires were administered. The Glasgow Benefit Inventory has four subscales which assess the patient's perception of the success of surgery, and the influence of surgery on the patients physical health, psychosocial function and social interaction. The Nasal Symptom Questionnaire (Fairley et al., 1993)--previously validated as an outcome measure in the context of FESS--was used to assess nasal symptoms. Multivariate and factor analysis was used to analyse the results. Four factors were extracted from the 103 responses to the Glasgow Benefit Inventory. The major factor of the benefit score was perception of surgical success which explained 50% of the variance. Three other factors (improvements in psychosocial functioning, social interaction and physical health after surgery) accounted for 10%, 5%, and 6% of the variance, respectively. Analysis of the Nasal Symptom Questionnaire yielded one predominant factor which was inversely related to perceived benefit. The outcome of rhinoplasty is influenced by the presence of nasal symptoms. Greater attention to nasal function would increase the benefit of rhinoplasty.