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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



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.


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.


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



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.).


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).


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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  1. Brettschneider C, Lühmann D, Raspe H (2011) Der Stellenwert von Patient Reported Outcomes (PRO) im Kontext von Health Technology Assessment (HTA). DIMDI, Köln

    Google Scholar 

  2. Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ (2010) The routine use of patient reported outcome measures in healthcare settings. BMJ 340:c186

    Article  Google Scholar 

  3. Staniszewska S, Haywood KL, Brett J, Tutton L (2012) Patient and public involvement in patient-reported outcome measures. Patient 5(2):79–87

    Article  Google Scholar 

  4. Baumann I (2010) Lebensqualität vor und nach Septum-und Rhinoplastik. Laryngorhinootologie 89(S 01):S35–S45

    Article  Google Scholar 

  5. Saleh AM, Younes A, Friedman O (2012) Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope 122(2):254–259.

    Article  PubMed  Google Scholar 

  6. Wähmann M, Bulut OC, Bran G, Veit J, Riedel F (2018) Systematic review of quality of life measurement after rhinoplasty [original]. Aesthetic Plast Surg.

    Article  PubMed  Google Scholar 

  7. Alsarraf R, Larrabee WF Jr., Anderson S, Murakami CS, Johnson CM Jr. (2001) Measuring cosmetic facial plastic surgery outcomes: a pilot study. Arch Facial Plast Surg 3(3):198–201

    CAS  Article  Google Scholar 

  8. Bulut C, Wallner F, Plinkert PK, Baumann I (2014) Development and validation of the Functional Rhinoplasty Outcome Inventory 17 (FROI-17). Rhinology 52(4):315–319.

    Article  PubMed  Google Scholar 

  9. Klassen AF, Cano SJ, East CA, Baker SB, Badia L, Schwitzer JA et al (2016) Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty. JAMA Facial Plast Surg 18(1):27–35.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bulut OC, Wallner F, Plinkert PK, Prochnow S, Kuhnt C, Baumann I (2015) Quality of life after septorhinoplasty measured with the Functional Rhinoplasty Outcome Inventory 17 (FROI-17). Rhinology 53(1):54–58.

    Article  PubMed  Google Scholar 

  11. Esteves SS, Ferreira MG, Almeida JC, Abrunhosa J, e Sousa CA (2016) Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study. Braz J Otorhinolaryngol.

    Article  Google Scholar 

  12. Faidiga GB, Carenzi LR, Yassuda CC, Silveira F, do Lago T, Leite MGJ et al (2010) Long-term evaluation in aesthetic rhinoplasty in an academic referral center. Braz J Otorhinolaryngol 76(4):437–441

    Article  Google Scholar 

  13. Hellings PW, Nolst Trenite GJ (2007) Long-term patient satisfaction after revision rhinoplasty. Laryngoscope 117(6):985–989.

    Article  PubMed  Google Scholar 

  14. Bulut OC, Plinkert PK, Wallner F, Baumann I (2016) Quality of life in functional rhinoplasty: rhinoplasty outcomes evaluation German version (ROE-D). Eur Arch Otorhinolaryngol 273(9):2569–2573.

    Article  PubMed  Google Scholar 

  15. Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157–163.

    Article  PubMed  Google Scholar 

  16. Izu SC, Kosugi EM, Brandao KV, Lopes AS, Garcia LB, Suguri VM et al (2012) Normal values for the Rhinoplasty Outcome Evaluation (ROE) questionnaire. Braz J Otorhinolaryngol 78(4):76–79

    Article  Google Scholar 

  17. Freiberg A, Giguere D, Ross DC, Taylor JR, Bell T, Kerluke LD (1997) Are patients satisfied with results from residents performing aesthetic surgery? Plast Reconstr Surg 100(7):1824–1831 (discussion 1832–1823)

    CAS  Article  Google Scholar 

  18. Spilker B (1990) Quality of life assessments in clinical trials. Psychol Med.

    Article  Google Scholar 

  19. Santanello NC, Baker D, Cappelleri JC, Copley-Merriman K, DeMarinis R, Gagnon JP et al (2002) Regulatory issues for health – related quality of life – PhRMA Health Outcomes Committee workshop, 1999. Value Health 5(1):14–25

    Article  Google Scholar 

  20. Dolan RW (2010) Minimally invasive nasal valve repair: An evaluation using the NOSE scale. Arch Otolaryngol Head Neck Surg 136(3):292–295.

    Article  PubMed  Google Scholar 

  21. Arima LM, Velasco LC, Tiago RS (2011) Crooked nose: outcome evaluations in rhinoplasty. Braz J Otorhinolaryngol 77(4):510–515

    Article  Google Scholar 

  22. Guyuron B, Bokhari F (1996) Patient satisfaction following rhinoplasty. Aesthetic Plast Surg 20(2):153–157

    CAS  Article  Google Scholar 

  23. Islam A, Arslan N, Felek SA, Celik H, Demirci M, Oguz H (2008) Reconstruction of the internal nasal valve: modified splay graft technique with endonasal approach. Laryngoscope 118(10):1739–1743.

    Article  PubMed  Google Scholar 

  24. Rohs FR, Langone CA, Coleman RK (2001) Response shift bias: a problem in evaluating nutrition training using self-report measures. J Nutr Educ 33(3):165–170

    CAS  Article  Google Scholar 

  25. Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg 24(3):192–197

    CAS  Article  Google Scholar 

  26. Meningaud JP, Lantieri L, Bertrand JC (2008) Rhinoplasty: an outcome research. Plast Reconstr Surg 121(1):251–257.

    CAS  Article  PubMed  Google Scholar 

  27. Schwitzer JA, Albino FP, Mathis RK, Scott AM, Gamble L, Baker SB (2015) Assessing demographic differences in patient-perceived improvement in facial appearance and quality of life following rhinoplasty. Aesthet Surg J 35(7):784–793.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Bulut OC, Wallner F, Oladokun D, Kayser C, Plath M, Schulz E et al (2018) Long-term quality of life changes after primary septorhinoplasty. Qual Life Res 27(4):987–991.

    Article  PubMed  Google Scholar 

  29. Cingi C, Eskiizmir G (2013) Deviated nose attenuates the degree of patient satisfaction and quality of life in rhinoplasty: a prospective controlled study. Clin Otolaryngol 38(2):136–141.

    CAS  Article  PubMed  Google Scholar 

  30. Honigman RJ, Phillips KA, Castle DJ (2004) A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg 113(4):1229

    Article  Google Scholar 

  31. Lohuis PJ, Hakim S, Duivesteijn W, Knobbe A, Tasman AJ (2013) Benefits of a short, practical questionnaire to measure subjective perception of nasal appearance after aesthetic rhinoplasty. Plast Reconstr Surg 132(6):913e–923e.

    CAS  Article  PubMed  Google Scholar 

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Correspondence to F. Riedel.

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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).

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


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