Association between mental health status and patient satisfaction with the functional outcomes of rhinoplasty

Erika Strazdins*, Yu Feng Nie, Raziqah Ramli, Tom Palesy, Jenna M. Christensen, Raquel Alvarado, George N. Marcells, Richard J. Harvey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Importance: Mental health can have an impact on patient satisfaction with rhinoplasty. However, the association between mental health and patient satisfaction with functional outcomes of rhinoplasty is poorly understood. Objective: To determine whether preoperative mental health is associated with satisfaction with functional outcomes of rhinoplasty. Design, setting, and participants: This case-control study assessed baseline nasal function and postsurgical functional outcomes for 88 consecutive patients undergoing rhinoplasty with both cosmetic and functional goals at 2 tertiary rhinologic centers in Sydney, Australia. Exposures: Poor mental well-being was defined preoperatively by the Optum SF-36v2 Health Survey mental component summary. Main outcomes and measures: Nasal function was assessed with patient-reported outcome measures, including visual analog scales, the Nasal Obstruction Symptom Evaluation Scale (NOSE), the 22-item Sinonasal Outcome Test (SNOT-22), and Likert scales. Objective outcomes included nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area. All outcomes were assessed preoperatively and 6 months postoperatively. The 36-item Optum SF-36v2 Health Survey mental component summary was used to assess mental well-being, with a score of less than 40 indicating poor mental well-being and a score 40 or higher indicating normal well-being. Results: Mean (SD) patient age was 37.6 (12.9) years and 53 of 88 (60.2%) were women. The mental component summary defined impaired well-being in n = 24 (cases) and normal well-being in n = 64 (controls). There were improvements in the total study population across most nasal function outcomes and in both groups. After rhinoplasty, benefit was seen for both groups in visual analog scale (left side mean [SD] change, 18 [30]; P < .001 and right side mean [SD] change, 24 [30]; P < .001); NOSE (mean [SD] change, 1.35 [1.21]; P < .001); and SNOT-22 (mean [SD] change, 0.81 [0.88]; P < .001) scores. Nasal peak inspiratory flow improved for both groups (mean [SD] change, 32 [45] L/min; P < .001), while nasal airway resistance and minimum cross-sectional area remained similar (change in nasal airway resistance, 0.086 Pa/cm3/s; 95% CI, −0.007 Pa/cm3/s to 0.179 Pa/cm3/s and change in minimum cross-sectional area, −0.04 cm2; 95% CI, −0.21 cm2 to 0.13 cm2). Patients with poor mental health had similar improvements in nasal function compared with controls. Conclusions and relevance: Rhinoplasty imparts similar benefits to nasal function assessed by patient-reported outcome measures and objective airflow measures regardless of preoperative mental health status.

Original languageEnglish
Pages (from-to)284-291
Number of pages8
JournalJAMA Facial Plastic Surgery
Issue number4
Publication statusPublished - 1 Jul 2018


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