Abstract：
OBJECTIVE: Satisfaction with the nasal appearance is a crucial outcome parameter in functional rhinoplasty (fRPL). The visual analogue scale is a suitable instrument not only for the preoperative patient assessment, but also as a patient-reported outcome measure in fRPL. In this study, we analyzed whether a high discrepancy in the preoperative subjective perception of the nasal appearance between patients and other individuals predicts a lower level of satisfaction with the postoperative result and hence a worse outcome of fRPL.
METHODS: Standardized facial pictures of patients (n = 80) who underwent fRPL were taken preoperatively, 3 and 12 months postoperatively. In addition, patients were asked to complete the German version of the Utrecht Outcome Assessment Questionnaire in Aesthetic Rhinoplasty (D-OAR). The standardized facial pictures of the patients were presented to surgeons as well as to examiners without a medical background, and they were asked to evaluate the patients\' nasal appearance using the visual analogue scale.
RESULTS: The external evaluation of patient\'s nasal appearance was 1.7 points higher in median than the patient\'s subjective perception (range -5.7-7.00). A large discrepancy between self- and external estimation significantly correlates with higher D-OAR values (r = 0.539, p < 0.001). Patients with high scores in the D-OAR trick questions, indicating a body dysmorphic disorder, show a significant larger discrepancy between the external- and the self-assessment (2.8 ± 0.5 vs. 1.4 ± 0.3, mean ± SEM, p = 0.017).
CONCLUSIONS: Large discrepancies between the self and external assessment of the nasal appearance are associated with a high-perceived influence of the appearance of the nose on the quality of life in patients undergoing functional rhinoplasty. That might be an indicator for unrealistic expectations concerning the postoperative outcome. Knowledge about this factor helps to identify the need for intensive discussion about possibilities and limitations of the planned procedure to avoid postoperative dissatisfaction.
METHODS: Standardized facial pictures of patients (n = 80) who underwent fRPL were taken preoperatively, 3 and 12 months postoperatively. In addition, patients were asked to complete the German version of the Utrecht Outcome Assessment Questionnaire in Aesthetic Rhinoplasty (D-OAR). The standardized facial pictures of the patients were presented to surgeons as well as to examiners without a medical background, and they were asked to evaluate the patients\' nasal appearance using the visual analogue scale.
RESULTS: The external evaluation of patient\'s nasal appearance was 1.7 points higher in median than the patient\'s subjective perception (range -5.7-7.00). A large discrepancy between self- and external estimation significantly correlates with higher D-OAR values (r = 0.539, p < 0.001). Patients with high scores in the D-OAR trick questions, indicating a body dysmorphic disorder, show a significant larger discrepancy between the external- and the self-assessment (2.8 ± 0.5 vs. 1.4 ± 0.3, mean ± SEM, p = 0.017).
CONCLUSIONS: Large discrepancies between the self and external assessment of the nasal appearance are associated with a high-perceived influence of the appearance of the nose on the quality of life in patients undergoing functional rhinoplasty. That might be an indicator for unrealistic expectations concerning the postoperative outcome. Knowledge about this factor helps to identify the need for intensive discussion about possibilities and limitations of the planned procedure to avoid postoperative dissatisfaction.
摘要：
目的：对鼻部外观的满意度是功能性鼻成形术（fRPL）的关键结果参数。视觉模拟量表是一种不仅适用于术前患者评估，但也作为fRPL患者报告的结果指标。在这项研究中,我们分析了术前患者和其他个体对鼻部外观的主观感知差异大,是否预示了患者对术后结果的满意度较低,因此fRPL的结果较差.
方法：术前拍摄接受fRPL的患者（n=80）的标准化面部照片，术后3个月和12个月。此外,患者被要求完成德文版的美学隆鼻手术乌得勒支结局评估问卷(D-OAR).患者的标准化面部照片被提供给外科医生以及没有医学背景的检查者，他们被要求使用视觉模拟量表评估患者的鼻腔外观。
结果：患者鼻部外观的外部评价中位数比患者的主观感知高1.7分（范围-5.7-7.00）。自我估计和外部估计之间的巨大差异与较高的D-OAR值显著相关(r=0.539,p<0.001)。在D-OAR技巧问题中得分高的患者，表明身体畸形，显示外部评估和自我评估之间存在显着较大的差异（2.8±0.5vs.1.4±0.3，平均值±SEM，p=0.017)。
结论：鼻部外观的自我和外部评估之间的巨大差异与鼻部外观对功能性鼻整理术患者生活质量的高度感知影响相关。这可能是对术后结果不切实际的期望的指标。有关此因素的知识有助于确定是否需要对计划程序的可能性和局限性进行深入讨论，以避免术后不满。
方法：术前拍摄接受fRPL的患者（n=80）的标准化面部照片，术后3个月和12个月。此外,患者被要求完成德文版的美学隆鼻手术乌得勒支结局评估问卷(D-OAR).患者的标准化面部照片被提供给外科医生以及没有医学背景的检查者，他们被要求使用视觉模拟量表评估患者的鼻腔外观。
结果：患者鼻部外观的外部评价中位数比患者的主观感知高1.7分（范围-5.7-7.00）。自我估计和外部估计之间的巨大差异与较高的D-OAR值显著相关(r=0.539,p<0.001)。在D-OAR技巧问题中得分高的患者，表明身体畸形，显示外部评估和自我评估之间存在显着较大的差异（2.8±0.5vs.1.4±0.3，平均值±SEM，p=0.017)。
结论：鼻部外观的自我和外部评估之间的巨大差异与鼻部外观对功能性鼻整理术患者生活质量的高度感知影响相关。这可能是对术后结果不切实际的期望的指标。有关此因素的知识有助于确定是否需要对计划程序的可能性和局限性进行深入讨论，以避免术后不满。
