This paper centres on defining and providing a patient-related outcome tool in rhinoplasty surgery. There are currently no validated tools specifically for cosmetic alteration of the nose alone. The authors devised specific scales within the FACE-Q framework to specifically assess the nose, nostrils and adverse sequalae of surgery. These were validated against existing reliable FACE-Q scales and Rasch measurement theory (RMT). RMT is basically a psychometric model to analyse categorical data, in this context, ‘satisfied versus dissatisfied’ and has been shown to be a reliable means of validation. This is a commendable aspect of this paper considering most surgeons probably use objective personal assessment of photos to describe results. The analysis did show the scales produced for nose and nostrils and adverse outcomes were reproducible. This means these cosmetic rhinoplasty specific FACE-Q scales can be used as a tool to determine patient satisfaction and surgeon specific outcomes. The sample populations studied were largely biased toward females. Anecdotally it is accepted male cosmetic rhinoplasty patients have generally lower postoperative satisfaction. It would have been useful to include these patients in such a validation study. In addition it is unclear how patients were recruited, thus there may be considerable selection bias for these results. Further, larger studies will reveal whether the FACE-Q tools developed here can apply across a heterogenous population of patients seeking cosmetic improvement of their nose.

Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty.
Klassen AF, Cano SJ, East CA, et al.
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Daniel B Saleh

Newcastle Hospitals, UK.

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