The MiRa scale, a new standardised scale for evaluating nasal deformities before and after septorhinoplasty: a prospective study comparing patient satisfaction and the surgeon's assessment

Summary

Objectives

The objective was to assess the reliability of a new standardised scale for evaluating nasal anomalies in order to compare the surgeon's assessment and patient satisfaction.

Design

Monocentric prospective cohort study.

Settings

First, we validated the reliability of the MiRa scale; then, we compared the surgeon's assessment and patient satisfaction.

Participants

Fifty-two patients underwent septorhinoplasty surgery and gave their written consent before inclusion.

Main outcome measurements

Primary outcome measurement was to validate the reliability of the MiRa scale: 2 observers analysed all records twice. Intra- and inter-observer reproducibility were evaluated using the intraclass correlation coefficient (ICC). Secondary outcome measurement was to compare the surgeon's assessment and patient satisfaction: MiRa and ROE (Rhinoplasty Outcome Evaluation) scores were established for each patient prior to and 6 months after surgery.

Results

Using the MiRa scale, ICC for intra- and inter-observer reproducibility were, respectively, 95.4% and 96%, showing no statistical difference (p=0.70, p=0.45). Good correlation scores were, respectively, 93% and 92%. Mean ROE scores were 7.1/24 (SD=11.3) before and 19.3/24 (SD=17.3) after surgery (p<0.05). We found an increase in MiRa and ROE scores of +19.75% and +51.25% (p<0.05), respectively. The average postoperative ROE score in the primary septorhinoplasty group was 20.4 (SD=14.4) and 17.2 (SD=23.1) in the secondary septorhinoplasty group (p<0.05).

Conclusion

MiRa scale is a reliable, standardised tool to evaluate surgical outcome in septorhinoplasty surgery. It provides an objective and reproducible score. The surgeon's assessment was more critical than patient satisfaction. Patient satisfaction is more difficult to achieve in cases involving a secondary septorhinoplasty.

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