Litner Jason A, Rotenberg Brian W, Dennis Maureen, Adamson Peter A
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
Arch Facial Plast Surg. 2008 Mar-Apr;10(2):79-83. doi: 10.1001/archfaci.10.2.79.
To assess perioperative quality-of-life (QOL) changes in a facial plastic surgery patient population and to ascertain factors determinative of QOL changes. A notable paucity of objective scientific measurements of QOL exists within the facial plastic surgery literature.
A 3-year prospective cohort study. The patient population, which comprised a consecutive series of patients 16 years or older, undergoing cosmetic nasal or facial surgery, was obtained from the senior author's (P.A.A.) private surgical practice. All patients presenting for surgery were offered participation. The main outcome measure was the 59-item Derriford Appearance Scale (DAS59), a valid and reliable instrument assessing psychological distress associated with self-consciousness of facial appearance. Three patient score subgroupings were established: group 1, the DAS59 scores for all patients; group 2, the DAS59 score according to sex; and group 3, the DAS59 score according to the main surgical procedure. Surveys were administered to eligible patients at the final preoperative clinic visit and at 3 months after surgery. Data from the case-control groups were analyzed by a blinded statistician with appropriate t tests.
A total of 93 patients were enrolled with a 100% response rate (82 females [88%] and 11 males [12%]). The most common procedures were rhinoplasty (49%) and surgery for the aging face (51%). Marked differences in perioperative QOL were noted across all DAS59 domains for group 1 and for all females in group 2. Male patients in group 2 analysis experienced QOL improvement only from DAS59 domain 2 (General Self-consciousness of Facial Appearance). Rhinoplasty and surgery for the aging face improved patients' QOL but differed with respect to which DAS59 domains were affected.
Quality of life was enhanced by facial plastic surgery in this patient population. Male and female patients seem to have different needs to be met from facial cosmetic surgery and correspondingly different areas of improvement in QOL. Rhinoplasty and surgery for the aging face act on different domains of QOL.
评估面部整形手术患者围手术期的生活质量（QOL）变化，并确定决定QOL变化的因素。面部整形手术文献中客观科学的QOL测量方法明显不足。
一项为期3年的前瞻性队列研究。患者群体来自资深作者（P.A.A.）的私人外科诊所，包括一系列连续的16岁及以上接受鼻部或面部整形手术的患者。所有前来手术的患者都被邀请参与。主要结局指标是59项的德里福德外貌量表（DAS59），这是一种有效且可靠的工具，用于评估与面部外观自我意识相关的心理困扰。建立了三个患者评分亚组：第1组，所有患者的DAS59评分；第2组，按性别划分的DAS59评分；第3组，按主要手术程序划分的DAS59评分。在术前最后一次门诊就诊时和术后3个月对符合条件的患者进行调查。病例对照小组的数据由一位不知情的统计学家通过适当的t检验进行分析。
共纳入93例患者，应答率为100%（82例女性[88%]和11例男性[12%]）。最常见的手术是隆鼻术（49%）和面部抗衰手术（51%）。第1组以及第2组中所有女性在所有DAS59领域的围手术期QOL都有显著差异。第2组分析中的男性患者仅在DAS59领域2（面部外观的总体自我意识）的QOL有所改善。隆鼻术和面部抗衰手术改善了患者的QOL，但在受影响的DAS59领域方面有所不同。
该患者群体的面部整形手术提高了生活质量。男性和女性患者似乎对面部整形手术有不同的需求，相应地在QOL改善的不同方面也有所不同。隆鼻术和面部抗衰手术作用于QOL的不同领域。
