Septorhinoplasty and its relevance to health outcomes: A prospective cohort study of functional and psychosocial outcomes.

BACKGROUND

Septorhinoplasty is commonly performed to address functional nasal obstruction and aesthetic concerns. While functional outcomes are well established, the relationship between functional improvement and psychosocial well-being remains incompletely understood.

METHODS

A prospective observational cohort study was conducted including 150 consecutive eligible and consenting adult patients undergoing septorhinoplasty at a tertiary referral centre. Patient-reported outcomes were assessed preoperatively and at 6 months postoperatively using the Nasal Obstruction Symptom Evaluation (NOSE) scale, a stress assessment questionnaire, and the World Health Organization Quality of Life instrument (WHOQOL-BREF). Changes in scores were analysed using the Wilcoxon signed-rank test, and associations between functional and psychosocial outcomes were assessed using Spearman's rank correlation coefficient.

RESULTS

All patients completed follow-up. The mean NOSE score improved significantly from 67.4 ± 18.2 to 21.6 ± 16.9 (p < 0.001), representing a mean reduction of 45.8 points that exceeded established thresholds for clinical relevance. Approximately 82% of patients achieved clinically meaningful improvement. Significant reductions in perceived stress were observed across most emotional and social domains (p < 0.05), while cognitive domains showed no significant change. WHOQOL-BREF analysis demonstrated significant improvements in the physical, psychological, and social domains (p < 0.001), with moderate-to-large effect sizes, whereas the environmental domain showed minimal change. A moderate association was observed between improvement in NOSE scores and psychological quality-of-life outcomes (r = 0.50, p < 0.05).

CONCLUSIONS

Septorhinoplasty was associated with significant improvements in nasal obstruction and multiple psychosocial outcomes at 6 months. Functional improvement was moderately associated with enhanced psychological well-being. These findings should be interpreted as associations rather than causal effects, because the observational design could not fully control for potential confounders, including baseline psychosocial status, surgical indication, patient expectations, aesthetic satisfaction, and procedure-specific factors.