焦虑和抑郁与功能和美学鼻整形术后患者报告结局的关联

文献信息

中文摘要

背景： 躯体变形障碍是鼻整形术后患者满意度下降的公认预测因素。然而，焦虑和抑郁对鼻整形特异性患者报告结局的影响在很大程度上尚不清楚。本研究评估焦虑和抑郁与功能和美学鼻中隔鼻整形术后患者满意度的关联。
方法： 这项单中心回顾性队列研究纳入了2019年至2024年接受功能或美学鼻中隔鼻整形的患者。从电子病历中提取术前和术后的鼻阻塞症状评估（NOSE）和标准化美容与健康鼻部结局调查（SCHNOS）评分。在功能和美学队列中，将患有焦虑和/或抑郁的患者与无这些诊断的患者进行比较。进行多变量逻辑回归以评估翻修率。
结果： 关于功能性鼻中隔鼻整形（n=490），对照组和焦虑/抑郁组术后NOSE（-44.7和-32.5，p<0.001）和SCHNOS-阻塞性（-44.9和-46.9，p<0.001）评分均改善。与对照组相比，焦虑/抑郁组报告更高的（较不有利的）术后NOSE（35.3 vs 24.1，p<0.001）和SCHNOS-阻塞性（32.1 vs 24.1，p=0.027）评分，以及更高的翻修手术几率（OR 2.56，95% CI 1.51-4.39，p<0.001）。关于美学鼻中隔鼻整形（n=179），对照组和焦虑/抑郁组术后SCHNOS-美容评分均改善（-32.3和-39.6，p<0.001），两组之间术前或术后SCHNOS-美容评分或翻修率无差异。
结论： 接受功能性鼻中隔鼻整形的焦虑或抑郁患者报告较低的术后满意度和较高的翻修率。相比之下，接受美学鼻中隔鼻整形的焦虑或抑郁个体与对照组相比，术后满意度或翻修手术无显著差异。

英文摘要

BACKGROUND: Body dysmorphic disorder is a well-established predictor of decreased patient satisfaction after rhinoplasty. However, the effect of anxiety and depression on rhinoplasty-specific patient reported outcomes is largely unknown. This study evaluates the association of anxiety and depression with patient satisfaction after functional and aesthetic septorhinoplasty.
METHODS: This single-center retrospective cohort study included patients undergoing functional or aesthetic septorhinoplasty from 2019-2024. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scores were extracted from the electronic medical record. Patients with anxiety and/or depression were compared to those without these diagnoses within functional and aesthetic cohorts. Multivariable logistic regression was performed to assess revision rates.
RESULTS: Regarding functional septorhinoplasty (n=490), both the control and anxiety/depression group demonstrated improved NOSE (-44.7 and -32.5, p<0.001) and SCHNOS-Obstructive (-44.9 and -46.9, p<0.001) scores postoperatively. Compared to the control group, the anxiety/depression group reported higher (less favorable) postoperative NOSE (35.3 vs 24.1, p<0.001) and SCHNOS-Obstructive (32.1 vs. 24.1, p=0.027) scores, and higher odds of revision surgery (OR 2.56, 95% CI 1.51-4.39, p<0.001). Regarding aesthetic septorhinoplasty (n=179), both the control and anxiety/depression group demonstrated improved SCHNOS-Cosmetic scores postoperatively (-32.3 and -39.6, p<0.001), with no difference in preoperative or postoperative SCHNOS-Cosmetic scores or revision rates between groups.
CONCLUSION: Patients with anxiety or depression undergoing functional septorhinoplasty reported lower postoperative satisfaction and experienced higher revision rates. In contrast, individuals with anxiety or depression undergoing aesthetic septorhinoplasty demonstrated no significant differences in postoperative satisfaction or revision surgery compared to controls.