Outcome Measures in Facial Plastic Surgery

Rhee, John S.; McMullin, Brian T.

doi:10.1001/archfaci.10.3.194

Cited by 66 publications

(18 citation statements)

References 174 publications

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“…For CFD to be useful to nasal surgeons, variables must be identified that reflect surgical changes and correlate with symptoms, e.g., feelings of congestion, blockage, breathing difficulties, sleep disturbance, and air hunger (Rhee and McMullin, 2008). Nasal resistance is affected by reduction in airway cross-sectional area and may relate to congestion and blockage.…”

Section: Introductionmentioning

confidence: 99%

Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction

Kimbell

Frank

Laud

et al. 2013

Journal of Biomechanics

102

175

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Surgeries to correct nasal airway obstruction (NAO) often have less than desirable outcomes, partly due to the absence of an objective tool to select the most appropriate surgical approach for each patient. Computational fluid dynamics (CFD) models can be used to investigate nasal airflow, but variables need to be identified that can detect surgical changes and correlate with patient symptoms. CFD models were constructed from pre- and post-surgery computed tomography scans for 10 NAO patients showing no evidence of nasal cycling. Steady-state inspiratory airflow, nasal resistance, wall shear stress, and heat flux were computed for the main nasal cavity from nostrils to posterior nasal septum both bilaterally and unilaterally. Paired t-tests indicated that all CFD variables were significantly changed by surgery when calculated on the most obstructed side, and that airflow, nasal resistance, and heat flux were significantly changed bilaterally as well. Moderate linear correlations with patient-reported symptoms were found for airflow, heat flux, unilateral allocation of airflow, and unilateral nasal resistance as a fraction of bilateral nasal resistance when calculated on the most obstructed nasal side, suggesting that these variables may be useful for evaluating the efficacy of nasal surgery objectively. Similarity in the strengths of these correlations suggests that patient-reported symptoms may represent a constellation of effects and that these variables should be tracked concurrently during future virtual surgery planning.

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Section: Introductionmentioning

confidence: 99%

Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction

Kimbell

Frank

Laud

et al. 2013

Journal of Biomechanics

102

175

View full text Add to dashboard Cite

show abstract

“…In this investigation, we also explored the question of whether the commonly used ClinRO− and ObsRO−based panel assessment tools have any correlation to the recently developed PRO−based FACE−Q tool. In the literature, the presence or absence of associations between two different outcome measurement tools has implications for the ongoing discussions on how to interpret and apply each existing measurement tool in clinical practice and research [44,45,46,47].…”

Section: Discussionmentioning

confidence: 99%

“…Despite these shortcomings, the results of the present study enable us to provide practical suggestions for future OGS−outcome−based research and clinical practice. Institutions, clinicians, healthcare networks, and policymakers use results from clinical trials as the foundation for healthcare decision−making when managing individual patients or particular populations [44,45,46,47,61,62,63,64]. To design valid and meaningful clinical trials, the fundamental issue is “which form of therapeutic management presents the highest possibility of being more beneficial for the least cost and inconvenience (i.e., risk–benefit ratio) to the patient as well as to the provider?” [61].…”

Section: Discussionmentioning

confidence: 99%

Facial Appearance and Psychosocial Features in Orthognathic Surgery: A FACE-Q- and 3D Facial Image-Based Comparative Study of Patient-, Clinician-, and Lay-Observer-Reported Outcomes

Denadai

Chou

et al. 2019

JCM

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Outcome measures reported by patients, clinicians, and lay-observers can help to tailor treatment plans to meet patients’ needs. This study evaluated orthognathic surgery (OGS) outcomes using pre- and post-OGS patients’ (n = 84) FACE-Q reports, and a three-dimensional facial photograph-based panel assessment of facial appearance and psychosocial parameters, with 96 blinded layperson and orthodontic and surgical professional raters, and verified whether there were correlations between these outcome measurement tools. Post-OGS FACE-Q and panel assessment measurements showed significant (p < 0.001) differences from pre-OGS measurements. Pre-OGS patients’ FACE-Q scores were significantly (p < 0.01) lower than normal, age-, gender-, and ethnicity-matched individuals’ (n = 54) FACE-Q scores, with no differences in post-OGS comparisons. The FACE-Q overall facial appearance scale had a low, statistically significant (p < 0.001) correlation to the facial-aesthetic-based panel assessment, but no correlation to the FACE-Q lower face and lips scales. No significant correlation was observed between the FACE-Q and panel assessment psychosocial-related scales. This study demonstrates that OGS treatment positively influences the facial appearance and psychosocial-related perceptions of patients, clinicians and lay observers, but that there is only a low, or no, correlation between the FACE-Q and panel assessment tools. Future investigations may consider the inclusion of both tools as OGS treatment endpoints for the improvement of patient-centered care, and guiding the health-system-related decision-making processes of multidisciplinary teams, policymakers, and other stakeholders.

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“…Considering the importance of using patient-oriented outcome measures to evaluate the efficacy of specific procedures, 23,24 we performed a study where rhinoplasty patients’ views on 2D computer imaging versus 3D were assessed using patient-reported outcome tools. To our knowledge, this is the first study that looks into patients’ responses on 2D versus 3D morphing in the same consultation, and demonstrates factors that may influence appreciation of 3D morphing as an added value over 2D.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional Morphing and Its Added Value in the Rhinoplasty Consult

Lekakis

Hens

Claes

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: The evolving literature on 3D surface imaging demonstrates that this technology is becoming the preferred simulation technique in hospitals and research centers. However, no study has demonstrated before the superiority of this facility over standard 2D simulation during preoperative evaluation in rhinoplasty. Methods: One hundred seventy-two consecutive patients requesting rhinoplasty were included. Patients answered a questionnaire following a 2D simulation and subsequently experienced 3D morphing. A single question was answered regarding the added value of the latter by patients and surgeons, respectively. Results: In our survey, satisfaction with 2D morphing reached 61%. Ninety-five percentage of the same group considered 3D simulation an added value over 2D. Additionally, 84% of patients requesting revision rhinoplasty admitted that 3D computer simulation has helped them understand the aims of surgery, in contrast to 61% of patients from the primary group. Furthermore, patients unsatisfied with their 2D simulation got reassured following 3D simulation to undergo surgery at a higher percentage (67%), compared with the group initially satisfied with 2D (48%). Women appeared reassured by 3D imaging in higher percentage (63%) compared with men (42%). The 2 surgeons, however, found 3D simulations to be an added value in 66% and 74% of all patients. Conclusions: The overwhelming majority of our patients considered 3D simulation an added value over 2D. Patients initially unsatisfied with 2D morphing, revision rhinoplasty patients, and women seemed to be the groups that appreciated more 3D than 2D computer simulation. In contrast, surgeons considered the facility of 3D an added value in two-thirds of the patients.

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Outcome Measures in Facial Plastic Surgery

Cited by 66 publications

References 174 publications

Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction

Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction

Facial Appearance and Psychosocial Features in Orthognathic Surgery: A FACE-Q- and 3D Facial Image-Based Comparative Study of Patient-, Clinician-, and Lay-Observer-Reported Outcomes

Three-dimensional Morphing and Its Added Value in the Rhinoplasty Consult

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