Khan Nasir, Rashid Mamoon, Khan Ibrahim, Ur Rehman Sarwar Saad, Ur Rashid Haroon, Khurshid Mariam, Khalid Choudry Usama, Fatima Noor
Plastic Surgery, Shifa International Hospital, Islamabad, PAK.
Dermatology, Pakistan Air Force Hospital, Islamabad, PAK.
Cureus. 2019 Jul 30;11(7):e5283. doi: 10.7759/cureus.5283.
Introduction Rhinoplasty is a challenging procedure. The goal of the surgery is not only to restore the function and youthful appearance of the nose but also to improve quality of life. With the passage of time, the trend has been changing rapidly from more invasive to less invasive procedures. Although the technical aspects of rhinoplasty are important, patient satisfaction is the factor that dictates the success of the procedure. Materials and methods A total of 118 rhinoplasties were performed in our department between 2016 and 2018. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was used to study the patients' satisfaction level. Ninety out of 118 patients took part in this study. Rhinoplasty was done using an open technique in all cases. The ROE questionnaire was filled preoperation and six months postoperation. Data analysis was done using SSPS statistic version 20 (IBM Corp., Armonk, NY, US). Results The main reasons for rhinoplasty in our patients were: aesthetic 23.3% (n=21), functional 25.5% (n=23), and a combination of both in 51% (n=46) patients. The mean ROE score of all patients preoperation was 30.5 (males: 31.3, females 29.8) and the mean score postoperation was 79.5 (males 78.2, females 80.9) at six months with no statistical differences (CI 17.11 - 12.59, P=0.762). However, both genders showed a statistically significant improvement between the preoperative and postoperative scores (mean difference = 49.3, CI 63.25 - 35.34, P<0.01), indicating an overall good satisfaction level after surgery. The satisfaction level of patients was inversely proportional to their level of understanding and knowledge of the surgical procedure. This difference was statistically significant ( CI 7.36-10.42, P<0.01). Minor corrections or modifications were done in eight patients under local anesthesia, with no significant difference in ROE scores as compared to those who had single surgery (CI 0.7 - 1.6, P=0.92). There was no statistically significant difference in the before and after surgery ROE scores among patients operated by different surgeons as well (P=0.82). Conclusion Our study shows that rhinoplasty, despite being a complex procedure, has proven benefits in terms of functional as well as aesthetic outcomes. The ROE questionnaire proves to be a valid tool for estimating patient satisfaction in our population. There is a need for further training and education of surgeons in Pakistan to improve the functional and aesthetic disabilities of nasal deformities.
引言
隆鼻手术是一项具有挑战性的手术。该手术的目标不仅是恢复鼻子的功能和年轻外观,还在于提高生活质量。随着时间的推移,手术趋势已迅速从侵入性更强的手术转向侵入性较小的手术。尽管隆鼻手术的技术方面很重要,但患者满意度是决定手术成功与否的因素。
材料与方法
2016年至2018年期间,我们科室共进行了118例隆鼻手术。使用隆鼻手术结果评估(ROE)问卷来研究患者的满意度水平。118例患者中有90例参与了本研究。所有病例均采用开放式技术进行隆鼻手术。ROE问卷在术前和术后六个月填写。使用SSPS统计软件20版(美国纽约州阿蒙克市IBM公司)进行数据分析。
结果
美容方面占23.3%(n = 21),功能方面占25.5%(n = 23),两者兼具的占51%(n = 46)。所有患者术前ROE平均得分为30.5(男性:31.3,女性:29.8),术后六个月平均得分为79.5(男性:78.2,女性:80.9),无统计学差异(置信区间17.11 - 12.59,P = 0.762)。然而,两性术前和术后得分之间均显示出统计学上的显著改善(平均差异 = 49.3,置信区间63.25 - 35.34,P < 0.01),表明手术后总体满意度良好。患者的满意度水平与其对手术过程的理解和了解程度成反比。这种差异具有统计学意义(置信区间7.36 - 10.42,P < 0.01)。八名患者在局部麻醉下进行了小的矫正或修改,与接受单次手术的患者相比,ROE得分无显著差异(置信区间0.7 - 1.6,P = 0.92)。不同外科医生手术的患者术前和术后ROE得分也无统计学显著差异(P = 0.82)。
结论
我们的研究表明,隆鼻手术尽管是一项复杂的手术,但在功能和美学效果方面已证明具有益处。ROE问卷被证明是评估我们人群中患者满意度的有效工具。巴基斯坦需要对外科医生进行进一步的培训和教育,以改善鼻畸形的功能和美学缺陷。