Leuven, Belgium; Ulm, Germany; and Crete, Greece From the Departments of Otorhinolaryngology, Head and Neck Surgery, and Psychiatry, University Hospitals Leuven; the Department of Otorhinolaryngology, Ulm University; the Department of Neurosciences, KU Leuven; and the Department of Otorhinolaryngology, University of Crete School of Medicine.
Plast Reconstr Surg. 2013 Apr;131(4):861-868. doi: 10.1097/PRS.0b013e3182818f02.
In patients seeking aesthetic rhinoplasty, a high prevalence of body dysmorphic disorder symptoms has recently been reported. However, the impact of these symptoms on the outcomes after rhinoplasty remains elusive. This large-scale study determines the influence of preoperative body dysmorphic disorder symptoms on patients' postoperative satisfaction and quality of life, using validated questionnaires.
A 1-year prospective study of 166 adult patients undergoing cosmetic rhinoplasty in a tertiary referral center was performed. Severity of body dysmorphic disorder symptoms was assessed by the modified Yale-Brown Obsessive Compulsive Scale. Postoperative satisfaction was evaluated using a visual analog scale for patients' appraisal of nasal shape and the Rhinoplasty Outcome Evaluation. Generic quality of life was quantified by the Sheehan Disability Scale, whereas the appearance-related disruption of everyday life was measured by the Derriford Appearance Scale-59.
Preoperative body dysmorphic disorder symptom scores inversely correlated with postoperative satisfaction at 3 months (visual analog scale nasal shape: rho = -0.43, p < 0.001; Rhinoplasty Outcome Evaluation: rho = -0.48, p < 0.001) and 12 months (rho = -0.40, p < 0.001; and rho = -0.41, p < 0.001, respectively) after surgery. In addition, body dysmorphic disorder symptom scores positively correlated with Sheehan Disability Scale scores and Derriford Appearance Scale-59 scores at 3 months (rho = 0.43, p < 0.001 and rho = 0.48, p < 0.001, respectively) and 12 months (rho = 0.32, p < 0.001, and rho = 0.48, p < 0.001, respectively) postoperatively.
This study provides the first evidence of the negative impact of preoperative body dysmorphic disorder symptoms on subjective outcomes after rhinoplasty, hence unveiling a crucial factor in patient dissatisfaction after aesthetic rhinoplasty.
最近有研究报道，在寻求美容鼻整形的患者中，躯体型躯体变形障碍症状的患病率较高。然而，这些症状对鼻整形术后结果的影响仍不清楚。本大规模研究使用经过验证的问卷来确定术前躯体型躯体变形障碍症状对患者术后满意度和生活质量的影响。
对在三级转诊中心接受美容鼻整形的 166 名成年患者进行了为期 1 年的前瞻性研究。使用改良耶鲁-布朗强迫症量表评估躯体型躯体变形障碍症状的严重程度。通过患者对鼻形的视觉模拟评分和鼻整形手术结果评估来评估术后满意度。使用 Sheehan 残疾量表量化一般生活质量，使用 Derriford 外貌量表-59 测量日常生活中因外貌而受到的干扰。
术前躯体型躯体变形障碍症状评分与术后 3 个月（鼻形视觉模拟评分：rho=-0.43，p<0.001；鼻整形手术结果评估：rho=-0.48，p<0.001）和 12 个月（rho=-0.40，p<0.001；和 rho=-0.41，p<0.001）时的术后满意度呈负相关。此外，躯体型躯体变形障碍症状评分与术后 3 个月（Sheehan 残疾量表：rho=0.43，p<0.001；Derriford 外貌量表-59：rho=0.48，p<0.001）和 12 个月（Sheehan 残疾量表：rho=0.32，p<0.001；Derriford 外貌量表-59：rho=0.48，p<0.001）时的 Sheehan 残疾量表评分和 Derriford 外貌量表-59 评分呈正相关。
本研究首次提供了术前躯体型躯体变形障碍症状对鼻整形术后主观结果的负面影响证据，从而揭示了美容鼻整形后患者不满意的一个关键因素。
