The Utrecht Questionnaire - Benefits of a Short, Practical Questionnaire to Measure Subjective Perception of Nasal Appearance after Aesthetic Rhinoplasty

Background: The evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is an increasing interest in self-reporting outcomes evaluation in plastic surgery. The authors tested a short, practically designed questionnaire to assess changes in the subjective perception of nasal appearance in patients before and after aesthetic rhinoplasty. Methods: A prospective cohort study was conducted in a group of 121 patients who desired aesthetic rhinoplasty and were operated on by one surgeon. The questionnaire contained five questions (E1-E5) based on a five-point Likert scale and a visual analogue scale (range, 0 to 10). Two questions were designed as trick questions to help the surgeon screen for signs of body dysmorphic disorder. Results: All patients rated the appearance of their nose as improved after surgery. The visual analogue scale revealed a Gaussian curve of normal distribution (range, 0.5 to 10) around a significant improvement (mean, 4.36 points, p=0.018). Also, question E1, question E2, and the sum of questions E1 through E5 showed a statistically significant improvement after surgery (p=1.74×10, p=4.29×10, and p=9.23×10, respectively). The authors found a linear relationship between the preoperative score on the trick questions and postoperative increase in visual analogue scale score. Test-retest reliability could be investigated in 74 of 121 patients (61 percent) and showed a positive correlation between postoperative (1 year after surgery) and repostoperative response (2 to 4 years after surgery). Conclusions: The authors concluded that a surgeon performing aesthetic rhinoplasty can benefit from using this questionnaire. It is simple, takes no more than 2 minutes to complete, and provides helpful subjective information regarding patient preoperative nasal appearance and postoperative surgical outcome