Harikalan Rajeswaran
Introduction
Predicting outcomes after septorhinoplasty remains challenging. This study examined whether age of symptom onset and revision status influence functional and aesthetic outcomes, with relevance to patient selection and counselling in day-case ENT surgery.
Methods
A retrospective cohort study was performed of all septorhinoplasty patients at a single institution between June 2022 and February 2026. PROMs, including NOSE and ROE scores, were collected pre- and postoperatively in line with GIRFT recommendations. Of 158 eligible patients, 122 had paired NOSE data and 88 paired ROE data. Patients were grouped as Early-Onset (≤16 years), Late-Onset Primary (>16 years, no previous nasal surgery), and Late-Onset Revision (>16 years, previous surgery).
Results
Baseline NOSE scores were similar across groups (p = 0.345). Postoperative functional improvement was greatest in Early-Onset patients, with 73% NOSE improvement compared with 63% in Late-Onset Primary and 41% in Late-Onset Revision cases (p = 0.013). Aesthetic improvement followed the same pattern (p = 0.002), with mean ROE increases of 44, 32, and 15 points, respectively. MCID success rates (>24-point NOSE reduction) were 98.2%, 82.6%, and 60.0% (p < 0.001).
Conclusions
Age of symptom onset and revision status strongly predict septorhinoplasty outcomes. Early-Onset patients achieve the greatest functional and aesthetic benefit, while revision cases demonstrate a clear revision penalty. These findings may improve counselling, expectation setting, and resource planning for day-case rhinoplasty services.
Author
Harikalan Rajeswaran, Frimley Health NHS Foundation Trust, Slough, United Kingdom
Mohamed Rayane Mejri, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
Roland Hettige, Frimley Health NHS Foundation Trust, Slough, United Kingdom