Therapeutic, III: Retrospective cohort or comparative study.
Our study group has researched for >10 years in the field of Quality of Life after plastic, aesthetic, and reconstructive surgery, asking the following questions: “Does aesthetic surgery improve the Quality of Life?” and “Can a higher Quality of Life offset the risk of surgical procedures.” As part of our series of studies examining the correlation of cosmetic surgery and the postoperative well-being, this study examines the influence of rhinoplasty, as a single indication, specifically on the Quality of Life (QoL) of patients. The data of 90 patients who underwent rhinoplasty between 1997 and 2007 were prospectively collected and were retrospectively analyzed. For a competitive analysis, our evaluation was divided into the following five parts: a self-developed indication-specific questionnaire and the standardized instruments Glasgow Benefit Inventory (GBI), Questions on Life SatisfactionModules (FLZM), Freiburg Personality Inventory (FPI-R), and Rosenberg Self-Esteem Questionnaire (RSES). Numerous improvements in patients' QoL were observed. The result of the GBI (17.19) based on a scale –100 to 100 indicates an improved QoL after rhinoplasty. Significant improvements in the item relationship/sexuality were shown in the general part of the FLZM (p = 0.042). The average score (6.32) on a scale of 0 to 14 in the FPI-R questionnaire resulted in a common emotionality and self-assessment, while the RSES (33.64) on a scale 10 to 40 indicated a high self-confidence and a statistically significant improvement (p = 0.0001) compared with German norm data. The knowledge of positive social and psychological benefits and an improved sexuality in the partnership support the meaningfulness of rhinoplasty.
As our previous studies have shown, cosmetic surgery has a positive correlation with postoperative well-being. The aim of this study was to prospectively examine the postoperative changes in quality of life (QoL) after a rhinoplasty. Thirty-four patients who underwent septorhinoplasty performed by a single surgeon from July 2015 to October 2018 reported in indication-specific self-developed and different validated questionnaires (FLZM or Fragen zur Lebenszufriedenheit Module, Freiburg Personality Inventor, Rosenberg self-esteem scale, Functional Rhinoplasty Outcome Inventory 17 [FROI-17], and Glasgow Benefit Inventory [GBI]) on the status of their QoL preoperatively (T0) and 6 months' follow-up (T1). Our goal was to assess the difference in psyche and self-esteem and to get objective insights into the effect of the operation. Significant improvements in QoL in terms of general module, health, and appearance were noted. The general part of the FLZM showed increasing T1 values in the sum scores (p = 0.005). With regard to the item “health,” T1 was better than the norm data (p = 0.003). The statistically significant improvement for the item nose appearance (p < 0.0001) after operation and T1 versus reference data (p < 0.010) should be highlighted. The subjective patient ratings showed statistically significant T1 improvements for all items of the FROI-17: overall nose (p < 0.0001), nasal function (p = 0.001), general/further symptoms (p = 0.006), and confidence increased by aesthetic changes (p < 0.0001). Furthermore, the GBI score shows an improved QoL after rhinoplasty (p < 0.0001). Based on the assessment of a variety of disease- and nondisease-specific validated questionnaires, numerous improvements in the QoL of the patients were observed. Therefore, we support septorhinoplasty as a meaningful procedure regarding QoL improvement. The level of evidence is Level II prospective cohort study.
BackgroundSurgical treatment of hallux valgus (HV) is one of the major flagships of orthopedic surgeons. Due to relatively unsatisfactory radiological and clinical outcomes, the search for the best surgical technique and causes for unsatisfactory outcomes continues. The objective was to investigate associations of the number of screws and additional surgical techniques for HV with radiological and clinical outcome after reversed L-shaped osteotomy (ReveL).MethodsA retrospective cohort study of adults from a single University Hospital between 2004 and 2013 was performed. The primary exposure was the number of screws (one vs two) used for osseous fixation after ReveL. The secondary exposure was an additional surgical technique for HV (e.g., Akin osteotomy). The primary outcome was a radiological recurrence of HV (HV angle (HVA) > 15°) at last follow-up. The secondary outcomes were limited patient satisfaction, complication, revision surgery, and elective hardware removal. Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression adjusting for confounders.ResultsThe recurrence was 45% less likely with the use of one screw, independent of age, sex, additional technique, and preoperative HVA (odds ratio (ORadjusted) = 0.55 [95% CI 0.30–0.98], p = 0.043). The recurrence was 162% more likely with an additional surgical technique for HV (ORadjusted = 2.62 [1.24–5.52], p = 0.011).ConclusionIn ReveL for HV, a single screw (instead of two screws) may be sufficient enough for a similar or even better outcome, which may also reduce costs. Additional surgical procedures for HV may be refrained from if possible. Due to limitations of a retrospective study, results may need validation with clinical trials.
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