A Comprehensive Quality-of-Life Instrument for Aesthetic and Functional Rhinoplasty: The RHINO Scale

Assessment of treatment efficacy and outcomes in rhinoplasty can be implemented using a variety of objective or subjective measures. A well-recognized criticism of objective outcome measures in rhinoplasty is the frequent and often significant divergence between objectively quantifiable measurements and subjective patient-reported outcomes.1 As a result, subjective quality-of-life (QOL) instruments have assumed an increasingly prevalent role in the assessment of outcomes after nasal surgery. This is intuitive to cosmetic nasal surgery as patient satisfaction is the most critical indicator of a successful outcome but is also equally as applicable to functional rhinoplasty. To this end, various QOL instruments have been developed to assess patient-reported outcomes after nasal surgery. Two of the most widely applied instruments include the Nasal Obstructive Symptom Evaluation (NOSE) scale and the Rhinoplasty Outcomes Evaluation (ROE) scale.2,3 The former has been used to study outcomes of functional rhinoplasty procedures and to create a severity scale for nasal obstruction.4–6 Studies using the latter scale, namely measuring aesthetic outcomes, have been much less common. It is interesting to note that both these validated instruments have segregated the assessment of aesthetic and functional outcomes after nasal surgery. In many ways, this is an artificial distinction as it is well accepted that nasal function and aesthetics are closely related. It is evident that to achieve successful results after rhinoplasty, patients must report satisfaction with both functional and aesthetic outcomes. The goal of this study was to develop and validate a comprehensive QOL instrument to assess patient satisfaction with functional and aesthetic outcomes after rhinoplasty.