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Secondary Cleft Rhinoplasty: Impact on Self-Esteem and Quality of Life

Roosenboom, Jasmien M.Sc.; Hellings, Peter W. M.D., Ph.D.; Picavet, Valerie A. M.D., Ph.D.; Prokopakis, Emmanuel P. M.D., Ph.D.; Antonis, Yasmine M.Sc.; Schoenaers, Joseph M.D., Ph.D.; Poorten, Vincent Vander M.D., Ph.D.; Claes, Peter Ir., Ph.D.; Hens, Greet M.D., Ph.D.

Plastic and Reconstructive Surgery: December 2014 - Volume 134 - Issue 6 - p 1285–1292
doi: 10.1097/PRS.0000000000000727
Pediatric/Craniofacial: Original Articles

Background: Rhinoplasty is one of the most challenging facial plastic procedures. Although patient satisfaction is the real outcome parameter in rhinoplasty, most authors have studied objective outcomes evaluated by professionals. The purpose of this study was to determine patient satisfaction after rhinoplasty in patients born with a cleft lip compared with outcome assessment by professionals, and to assess the impact of the procedure on appearance-related distress and generic quality of life.

Methods: Patient evaluation of the nose was performed before and 1 year after secondary cleft rhinoplasty (n = 33) using a visual analogue scale for nasal function and shape, and the Rhinoplasty Outcome Evaluation. General sinonasal complaints were evaluated using the Sino-Nasal Outcome Test. Appearance-related psychological distress was measured using the Derriford Appearance Scale. The Sheehan Disability Scale evaluated quality of life. Aesthetic outcome was evaluated by scoring of preoperative and postoperative photographs by two independent surgeons.

Results: One year postoperatively, patients showed significantly higher visual analogue scale scores for nasal shape (p < 0.0001) and function (p = 0.005) and higher Rhinoplasty Outcome Evaluation (p < 0.0001) scores. Correspondingly, Sino-Nasal Outcome Test scores were lower (p = 0.006). The appearance-related psychological distress was lower (p < 0.0001), and the generic quality of life was increased after rhinoplasty (p = 0.01). No correlation was found between patient outcome evaluation and surgeons’ scores.

Conclusion: There is high patient satisfaction at 12 months after secondary cleft rhinoplasty, resulting in a significant improvement of self-esteem and generic quality of life.


Leuven, Belgium; Ulm, Germany; and Iraklion, Crete, Greece

From the Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven; Multidisciplinary Cleft Lip and Palate Team, the Departments of Otorhinolaryngology, Head and Neck Surgery, Psychiatry, and Maxillo-Facial Surgery, University Hospitals Leuven; Medical Image Computing, ESAT/PSI, Department of Electrical Engineering, KU Leuven, Medical Imaging Research Center, KU Leuven & UZ Leuven, iMinds-KU Leuven Future Health Department; Universitätsklinik für Hals-Nasen-Ohrenheilkunde Ulm; and the Department of Otorhinolaryngology, University of Crete School of Medicine.

Received for publication February 27, 2014; accepted May 8, 2014.

Disclosure: None of the authors has any financial conflict of interest with the information presented in this article.

Greet Hens, M.D., Ph.D., Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium,

©2014American Society of Plastic Surgeons