Role of pre-operative assessment on the results of rhinoplasty in terms of patient satisfaction

ABSTRACT

The objectives of the study was to find out the importance of preoperative psychological assessment of patients in rhinoplasty and significance of excluding patients with psychiatric disorders, particularly Body dysmorphic disorder [BDD], on the overall results of surgery in terms of patient satisfaction. Randomized control trails [RCT]. This study was carried out at ENT out patients department [OPD], PNS Shifa and CMH Okara from January 2004 to Dec 2007. Patients complaining of nasal deformity with or without nasal obstruction were included in the study. A total of 85 [47 females and 38 males] patients were selected. After detailed history, examination and counseling 45 patients were selected by simple random method for psychological assessment and 40 patients not to have psychological assessment. The psychiatrist used DSM-IV TR criteria for psychological assessment and diagnosed 08 patients to be suffering from BDD and did not clear them for cosmetic surgery. Thirty seven patients being cleared for rhinoplasty [group A] and 40 patients [group B] not having psychological assessment, a total of 77 patients [42 females and 35 males] were offered cosmetic rhinoplasty. Patients were followed up for 01 year to check whether they were satisfied or not with postoperative results. The statistical data in the two groups was separately analyzed. Then by applying chi-square test the association in both the groups was calculated. Postoperatively 36/37 patients in group A were satisfied with their postoperative appearance and 32/40 patients in group B were satisfied. Chi-square test revealed the probability of <0.005, which is significant. Preoperative psychological assessment of patients has a significant role in patients undergoing cosmetic rhinoplasty as far as postoperative appearance is concerned