What question did this study set out to answer?

The study aims to evaluate factors that influence quality of life improvement after septorhinoplasty and to determine the minimal clinically important difference.

April 23, 2026Aesthetic Plastic Surgery0 citationsOpen Access

Factors on Quality of Life Improvement in Septorhinoplasty: Prospective Evaluation Using the Functional Rhinoplasty Outcome Inventory 17 and Its Minimally Important Difference

GKGeorg-Philipp KuehlHeidelberg University OBOlcay Cem BulutTechnische Hochschule Mannheim PSPatrick J. SchulerHeidelberg University

Key Points

The study aims to evaluate factors that influence quality of life improvement after septorhinoplasty and to determine the minimal clinically important difference.
Assessing HRQOL using FROI-17 pre- and 12 months post-surgery
Collecting clinical parameters such as age, sex, nasal deformity
Calculating MCID based on internal anchors
Mean FROI-17 scores improved significantly from 38.0 to 24.5 (p < 0.001)
Preoperative FROI-17 scores were identified as the strongest predictor of quality of life improvement (p < 0.001)
An MCID of 13.4 was calculated, aligning with the average postoperative improvement.

Abstract

Abstract Background Septorhinoplasty (SRPL) is a frequently performed surgery aimed to improve health-related quality of life (HRQOL), typically assessed using disease-specific questionnaires. This study aimed to analyze the factors influencing postoperative HRQOL improvement and to establish the minimal clinically important difference (MCID) for the Functional Rhinoplasty Outcome Inventory (FROI-17). Methods In this prospective study, pre- and twelve months postoperative, disease-specific HRQOL was assessed in 95 patients undergoing functional SRPL (Level of Evidence III). Clinical parameters including age, sex, surgical approach, type of nasal deformity, revision surgery and screening on body dysmorphic disorder were obtained. The primary endpoint was the change in FROI-17 scores. MCID was calculated with an internal anchor. Results Mean FROI-17 scores improved from 38.0 ± 16.0 to 24.5 ± 20.0 ( p < 0.001). Uni- and multivariate analysis identified the preoperative FROI-17 as the strongest predictor of QoL improvement ( p < 0.001). Only the preoperative nasal shape ( p = 0.02) and the BDD screening result ( p = 0.04) also showed significant correlations in the univariate analysis. The subcategory “self-consciousness" of the FROI-17 showed high sensitivity and specificity for the BDD screening results. An MCID of 13.4 points was calculated, matching the mean postoperative improvement in this cohort. Conclusions The preoperative FROI-17 score serves as a reliable predictor of postoperative HRQOL improvement following SRPL. These findings underscore the value of implementing patient-reported outcome measures such as the FROI-17 in preoperative counseling to enhance transparency and long-term patient satisfaction. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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