Overall quality of life impact on candidates for septorhinoplasty according to the World Health Organization quality of life brief questionnaire (WHOQOL-Brief)

Abstract Introduction: Quality of life has been an increasingly reference measure in whole health impact of diseases and in septorhinoplasty evaluation as well. It is known that the decision for this elective surgical procedure requires the subjective perception of patients’ complaints about their own health and life stage in association with the surgeon’s aesthetic and functional perspective of each case. Objective: To define the quality of life of candidates for septorhinoplasty using the World Health Organization quality of life questionnaire, WHOQOL-Brief, and the prevalence of other independent variables for this population. Methods: A cross-sectional study using a sample of candidates for septorhinoplasty was performed. All patients responded to the WHOQOL-Brief during the pre-operative period. A normative population quality of life study was the reference for the sample size and means. Results: A total of 302 patients were included among the 322 eligible patients. Twenty patients did not complete the questionnaire correctly and were excluded from the study. The sample consisted of patients aged between 15 and 78 years (34.7±14 years): the most majority were Caucasian and female. Among this group, 88.1% declared symptoms of nasal obstruction and 77.4% complained of sleeping problems. It was seen that 10.9% patients chose the surgery primarily for aesthetic improvement; 37.1% chose it mainly because of functional symptoms and 52% chose it for both functional and aesthetic reasons. The physical health domain’s mean was 62.2 ± 17), which is a higher mean compared to the references’ standard one (Μ = 58.9± 10.5, p = 0.002). The social relationship domain mean was 70.8±18.1; that is a lower mean then general population’s one (Μ = 76.2± 18.8, p < 0.001). The psychological and the environment domain means revealed no difference when comparing the sample to the norm (μ = 65.3 ±15.1 vs. μ = 65.9 ±10.8, p = 0.530 and μ = 60.3 ±13.1 vs. μ = 59.9 ± 14.9, p = 0.667). Conclusion: The WHOQOL-Brief questionnaire proved an accurate instrument to cross-check different populations in quality of life outcomes. The study provides good evidence of lower quality of life in social relations domain and high prevalence of nasal obstruction and sleeping symptoms in candidates for septorhinoplasty. This study contributes to recent literature with relevant data supporting a more integrative evaluation in this population in the preoperative period. The results may also encourage a multidisciplinary approach for chronic symptoms when associated with nasal obstruction, sleep disorders and aesthetic complaints.

引言：生活质量已逐渐成为衡量疾病整体健康影响与鼻中隔鼻成形术（septorhinoplasty）疗效评估的重要参考指标。众所周知，该择期手术的决策需兼顾患者对自身健康与生活状态的主观诉求，以及术者针对每一例病例的美学与功能层面的个体化评估。

研究目的：借助世界卫生组织生活质量评定简表（WHOQOL-Brief），明确鼻中隔鼻成形术候选人群的生活质量水平，并分析该人群中其他自变量的分布情况。

研究方法：本研究为横断面研究（cross-sectional study），纳入鼻中隔鼻成形术候选人群作为研究样本。所有受试者于术前完成WHOQOL-Brief问卷调研，本研究的样本量计算与均值参考依据均来自一项标准化人群生活质量研究。

研究结果：本研究共纳入322例符合入组标准的患者中的302例，其中20例因问卷填写不合格被排除。研究样本的年龄区间为15~78岁，平均年龄为(34.7±14)岁；受试者以白种人与女性居多。该人群中，88.1%的受试者自述存在鼻塞症状，77.4%存在睡眠障碍。其中10.9%的患者选择手术主要出于美学改善需求，37.1%的患者主要因功能症状选择手术，剩余52%的患者则同时出于功能与美学两方面的考量。躯体健康领域的平均得分为(62.2±17)，高于参照标准的均值(μ=58.9±10.5，p=0.002)。社会关系领域平均得分为(70.8±18.1)，低于普通人群的均值(μ=76.2±18.8，p<0.001)。心理健康领域与环境领域的得分与参照标准无显著统计学差异(分别为μ=65.3±15.1 vs. μ=65.9±10.8，p=0.530；μ=60.3±13.1 vs. μ=59.9±14.9，p=0.667)。

研究结论：WHOQOL-Brief问卷可作为跨人群生活质量结果评估的可靠工具。本研究证实鼻中隔鼻成形术候选人群在社会关系领域的生活质量更低，且鼻塞与睡眠症状的患病率较高。本研究为近期相关学术文献提供了高质量数据，支持该人群术前需开展更具整合性的评估。本研究结果或可推动针对伴随鼻塞、睡眠障碍与美学诉求的慢性症状采取多学科诊疗模式。