Ke X, Yang Y C, Shen Y, Liu J, Huang J J, Hong S L
Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Mar 7;55(3):223-229. doi: 10.3760/cma.j.issn.1673-0860.2020.03.007.
To explore the subjective and objective evaluation methods in functional rhinoplasty. Sixty-four patients who underwent rhinoplasty in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University were included in this study from January 2017 to October 2018. There were 32 males and 32 females, with the age ranging from 18 to 45 years old. Before and 6 months after operation, nasal ventilation function was evaluated by Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal acoustic reflex and nasal resistance. Satisfaction with nasal appearance was evaluated by VAS, Rhinoplasty Outcome Evaluation (ROE) and facial proportions evaluation. Psychological state was assessed by Emotional Balance Scale and Rosenberg Self-esteem Scale. Finally, the correlation analysis of patient satisfaction was performed. SPSS 23.0 software was used for statistical analysis. Compared with pre-operation, nasal obstruction VAS, NOSE scores, total nasal resistance and difference ratio of nasal resistance showed significantly decline after surgery (1.62±0.85 7.56±1.44, 22.62±3.54 69.75±7.85, (0.16±0.08) Pa·s/ml (0.31±0.43) Pa·s/ml, 0.33±0.28 0.71±0.32, all 0.05). VAS of appearance and ROE scores showed an increase after surgery (11.20±3.66 2.70±0.97, 17.80±2.71 7.50±1.12, all 0.05). The measurement of the external nasal subunits showed that the length of the dorsum of the nose, the angle of the face to the nose, the angle of the frontal and the angle of the alar of the nose were obviously reduced ((29.33±4.26) mm (33.61±5.24) mm, (135.11±3.81)° (139.91±6.30)°, (130.63±2.88)° (136.74±5.72)°, (99.71±4.02)° (106.27±5.60)°, all 0.05). The scores of postoperative Emotional Balance Scale and Rosenberg Self-esteem Scale increased significantly (5.88±1.54 4.31±1.85, 28.31±2.64 22.13±2.77, all 0.05). The correlation analysis showed that patients' satisfaction was positively correlated with subjective score of nasal ventilation (VAS, NOSE), subjective score of nasal appearance (VAS, ROE) and emotional balance scale, while negatively correlated with nasal resistance, and not correlated with the measurement of external nasal subunit. There was a significant positive correlation between the subjective score of nasal ventilation and the measurement of nasal resistance, but there was no significant correlation between the subjective score of nasal appearance and the measurement of external nasal subunit. The subjective and objective evaluation of nasal ventilation function, aesthetics of nasal appearance and psychological state can evaluate the effect of functional rhinoplasty effectively.
探讨功能性鼻整形术中主观及客观评估方法。选取2017年1月至2018年10月在重庆医科大学附属第一医院耳鼻咽喉科行鼻整形术的64例患者纳入本研究。其中男性32例，女性32例，年龄18～45岁。分别于术前及术后6个月采用视觉模拟评分法（VAS）、鼻阻塞症状评估量表（NOSE）、鼻声反射及鼻阻力对鼻通气功能进行评估；采用VAS、鼻整形术效果评估量表（ROE）及面部比例评估对鼻部外观满意度进行评估；采用情绪平衡量表及罗森伯格自尊量表对心理状态进行评估。最后进行患者满意度的相关性分析。采用SPSS 23.0软件进行统计学分析。与术前比较，术后鼻阻塞VAS、NOSE评分、总鼻阻力及鼻阻力差值比均显著下降（1.62±0.85比7.56±1.44，22.62±3.54比69.75±7.85，(0.16±0.08)Pa·s/ml比(0.31±0.43)Pa·s/ml，0.33±0.28比0.71±0.32，均P<0.05）。外观VAS及ROE评分术后升高（11.20±3.66比2.70±0.97，17.80±2.71比7.50±1.12，均P<0.05）。鼻外部亚单位测量显示，鼻背长度、面鼻角、额鼻角及鼻翼角明显减小（(29.33±4.26)mm比(33.61±5.24)mm，(135.11±3.81)°比(139.91±6.30)°，(130.63±2.88)°比(136.74±5.72)°，(99.71±4.02)°比(106.27±5.60)°，均P<0.05）。术后情绪平衡量表及罗森伯格自尊量表评分显著升高（5.88±1.54比4.31±1.85，28.31±2.64比22.13±2.77，均P<0.05）。相关性分析显示，患者满意度与鼻通气主观评分（VAS、NOSE）、鼻部外观主观评分（VAS、ROE）及情绪平衡量表呈正相关，与鼻阻力呈负相关，与鼻外部亚单位测量无相关性。鼻通气主观评分与鼻阻力测量有显著正相关，鼻部外观主观评分与鼻外部亚单位测量无显著相关性。对鼻通气功能、鼻部外观美学及心理状态的主观和客观评估可有效评价功能性鼻整形术的效果。
