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Comparing the Health Burden of Living With Nasal Deformity in Actual Patients and Healthy Individuals

A Utility Outcomes Score Assessment

Aldihan, Khalid MBBS*; Alnasyan, Abdulmalik MBBS*; Albassam, Abdullah MBBS*; Alghonaim, Yazeed MD, FRCSC*,†; Aldekhayel, Salah MD, MEd, FRCSC*,†

doi: 10.1097/SAP.0000000000002065
Aesthetic Surgery

Background Rhinoplasty is a one of the most commonly performed facial surgery aiming at restoring facial aesthetics and improving quality of life. Utility outcome scores are modern, and emerging tools are used to evaluate the burden of a health state on individuals. The study aims to evaluate the impact of living with nasal deformity among real patients and healthy individuals using utility outcome scores.

Methods A cross-sectional study was conducted at Otolaryngology and Plastic Surgery clinics in a tertiary center. Healthy individuals were recruited from public facilities. A case scenario was developed to reflect an imaginary patient (Nora) with a functional and aesthetic nasal deformity and distributed to participants. Three utility outcomes scores were used: visual analog scale (VAS), time trade-off (TTO), and standard gambling (SG).

Results A total of 407 adult participants were included. Most participants were female (52%). Healthy individuals comprised 71%, and actual patients comprised 29%. Mean VAS score was 0.77 (ie, participants scored Nora's health state as 77%), TTO score was 0.87 (ie, participants were willing to sacrifice 4 years to have Nora's condition corrected), and SD score was 0.91 (ie, participants were willing to take a 9% risk of death to have Nora's condition corrected). Scores differed among actual patients and healthy individuals (P < 0.0001 for VAS and TTO, P = 0.02 for SG).

Conclusion Living with a nasal deformity has a significant impact on quality of life. Both patients and healthy individuals are willing to trade a significant number of years to get the condition corrected.

From the *College of Medicine, King Saud bin Abdulaziz University for Health Sciences

King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

Received November 19, 2018, and accepted for publication, after revision July 7, 2019.

This work has not been presented at any meeting.

Conflicts of interest and sources of funding: none declared.

Reprints: Salah Aldekhayel, MD, MEd, FRCSC, Plastic Surgery Division, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia. E-mail:

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