A Systematic Review of Randomized Control Trials on Patient-Reported Outcome Measures in Rhinoplasty.

Abstract

Patient-reported outcome measures (PROMs) are crucial for evaluating rhinoplasty outcomes, yet no standardized, validated PROM tailored to rhinoplasty exists. This systematic review examines existing PROMs, identifying gaps in their ability to capture both aesthetic and functional outcomes. A PRISMA-compliant systematic review was conducted using MEDLINE, Embase, Google Scholar, CENTRAL, Science Citation Index, and PubMed. The protocol was registered a priori (CRD42024513514). Risk of bias was assessed using Cochrane's Risk of Bias Tool, with study quality evaluated via the validated GRADE tool. Twelve randomized controlled trials involving 743 patients were analyzed. The mean follow-up was 9.1 months, with a mean patient age of 35.35 years (±5.95) and a male-to-female ratio of 1:1.91. Ten distinct PROMs were identified, with FACE-Q emerging as the most robust, meeting 19 of 21 development standards. However, FACE-Q lacked the ability to assess functional outcomes critical to rhinoplasty, such as nasal airway function and breathing. This review highlights the heterogeneity of PROMs in rhinoplasty research and the limitations of current tools in addressing both aesthetic and functional outcomes. While FACE-Q is the most robust for aesthetic evaluation, its functional limitations underscore the need for refinement or a dedicated PROM tailored to the comprehensive demands of rhinoplasty.