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Lebensqualität nach funktionell-ästhetischer Septorhinoplastik in primärer Operation vs. in Revisionsoperation – eine monozentrische Studie

Quality of life after functional aesthetic septorhinoplasty in primary surgery vs. revision surgery—a monocentric study

An Im Fokus to this article was published on 14 February 2019

Zusammenfassung

Hintergrund

Subjektive Bewertungen der Lebensqualität haben als Ergebnisqualität in den letzten Jahrzehnten an Bedeutung gewonnen. Die Anzahl der prospektiven Studien zur Lebensqualitätsmessung mit krankheitsspezifischen Messinstrumenten ist überschaubar. Ziel war es, die Lebensqualität nach primärer und Revisionsseptorhinoplastik eines einzelnen Chirurgen in einem HNO(Hals-Nasen-Ohrenheilkunde)-Zentrum zu untersuchen.

Studiendesign und Untersuchungsmethoden

Präoperativ und mindestens ein Jahr postoperativ wurden 2 krankheitsspezifische Lebensqualitätsmessinstrumente eingesetzt: der ROE(„rhinoplasty outcome evaluation“)- und der NOSE(„nasal obstruction symptome evaluation“)-Score. Weitere Informationen, insbesondere Alter, Geschlecht und Voroperationen, wurden erfragt.

Ergebnisse

Es wurden 237 Patienten in die Studie eingeschlossen, 208 (87,8 %) weibliche, 29 (12,2 %) männliche. Das Durchschnittsalter lag bei 30,3 ± 8,9 Jahren, der durchschnittliche Beobachtungszeitraum bei 19,3 ± 7,4 Monaten. Alle Operationen wurden von demselben Chirurgen (F. R.) durchgeführt. Mit dem Messinstrument NOSE zeigte sich eine signifikante Verbesserung der Obstruktion im Gesamtkollektiv (präoperativ 49,8 ± 26,2, postoperativ 19,1 ± 21,3; p < 0,001), ohne signifikanten Unterschied in Bezug auf primäre vs. Revisionsoperation. Der ROE-Score verbesserte sich signifikant, beide Kollektive (primär und sekundär operierte) zeigten beide Kollektive eine signifikante Verbesserung nach der Intervention. Postoperativ fielen die Patienten mit einer Primärintervention durch eine signifikant höheren Lebensqualität (p < 0,001) auf.

Schlussfolgerung

Die krankheitsspezifische Lebensqualität nimmt nach primärer Septorhinoplastik wie nach Revisionsoperation signifikant zu. Der NOSE-Score stieg in beiden Interventionsgruppen postoperativ signifikant an.

Abstract

Background

Subjective assessments of quality of life (QOL) as an important aspect of outcome research have gained in importance over the past few decades. The number of prospective studies on postoperative QOL in septorhinoplasty using disease-specific instruments is sparse. The aim was to assess and compare patient QOL after primary and revision septorhinoplasty performed by a single surgeon in an ENT center.

Material and methods

All patients completed two disease-specific QOL instruments preoperatively and at least 1 year postoperatively: the Rhinoplasty Outcome Evaluation (ROE) and the Nasal Obstruction Symptoms Evaluation (NOSE) scores. General demographic and clinical information (age, gender, medical and surgical history) were collected from all patients. All operations were performed by a single surgeon (F. R.).

Results

A total of 237 patients were included in the study, 208 (87.8%) female and 29 (12.2%) male. The average age was 30.3 ± 8.9 years. The average observation period was 19.3 ± 7.4 months. Using the measurement tool NOSE there was a significant improvement in obstruction in the overall collective (preoperative 49.8 ± 26.2, postoperative 19.1 ± 21.3; p < 0.001) with no significant difference in primary versus revision surgery. The ROE score showed a significant improvement and both collectives (primary and secondary surgery) showed a significant improvement after the intervention. The patients with a primary intervention had a significantly higher postoperative QOL (p < 0.001).

Conclusion

The disease-specific QOL showed a significant increase after primary septorhinoplasty as well as after revision surgery. The NOSE score increased significantly in both intervention groups postoperatively.

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Correspondence to F. Riedel.

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Interessenkonflikt

F. Riedel, M. Wähmann, G. M. Bran, M. Conder und O. C. Bulut geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Riedel, F., Wähmann, M., Bran, G.M. et al. Lebensqualität nach funktionell-ästhetischer Septorhinoplastik in primärer Operation vs. in Revisionsoperation – eine monozentrische Studie. HNO 67, 192–198 (2019). https://doi.org/10.1007/s00106-018-0554-x

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  • DOI: https://doi.org/10.1007/s00106-018-0554-x

Schlüsselwörter

  • Nasale Obstruktion
  • Rhinoplastik
  • Outcome Assessment im Gesundheitswesen
  • Patientenzufriedenheit
  • Lebensqualität

Keywords

  • Nasal obstruction
  • Rhinoplasty
  • Outcome assessment (health care)
  • Patient satisfaction
  • Quality of life