title: The MiRa scale, a new standardised scale for evaluating nasal deformities before and after septorhinoplasty: A prospective study comparing patient satisfaction and the surgeon's assessment.
abstract: OBJECTIVE
  The objective was to assess the reliability of a new standardised scale for evaluating nasal anomalies in order to compare the surgeon's assessment and patient satisfaction.
  
  
  METHODS
  Monocentric prospective cohort study.
  
  
  METHODS
  First, we validated the reliability of the MiRa scale; then, we compared the surgeon's assessment and patient satisfaction.
  
  
  METHODS
  Fifty-two patients underwent septorhinoplasty surgery and gave their written consent before inclusion.
  
  
  METHODS
  Primary outcome measurement was to validate the reliability of the MiRa scale: two observers analysed all records twice. Intra-observer reproducibility and interobserver reproducibility were evaluated using the intraclass correlation coefficient (ICC). Secondary outcome measurement was to compare the surgeon's assessment and patient satisfaction: MiRa and ROE (Rhinoplasty Outcome Evaluation) scores were established for each patient prior to and 6 months after surgery.
  
  
  RESULTS
  Using the MiRa scale, ICC for intra- and interobserver reproducibility was, respectively, 95.4% and 96%, showing no statistical difference (P=.70, P=.45). Good correlation scores were, respectively, 93% and 92%. Mean ROE scores were 7.1/24 (SD=11.3) before and 19.3/24 (SD=17.3) after surgery (P<.05). We found an increase in MiRa and ROE scores of +19.75% and +51.25% (P<.05), respectively. The average postoperative ROE score in the primary septorhinoplasty group was 20.4 (SD=14.4) and 17.2 (SD=23.1) in the secondary septorhinoplasty group (P<.05).
  
  
  CONCLUSIONS
  MiRa scale is a reliable, standardised tool to evaluate surgical outcome in septorhinoplasty surgery. It provides an objective and reproducible score. The surgeon's assessment was more critical than patient satisfaction. Patient satisfaction is more difficult to achieve in cases involving a secondary septorhinoplasty.
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.|Aix-Marseille University, Marseille Cedex, France.
authors.forename: T
authors.identifier: http://orcid.org/0000-0002-5939-5372
authors.initials: T
authors.lastname: Radulesco
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Penicaud
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.|Aix-Marseille University, Marseille Cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Santini
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.|Aix-Marseille University, Marseille Cedex, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Thomassin
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.|Aix-Marseille University, Marseille Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Dessi
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique Hôpitaux de Marseille, La Conception University Hospital, Marseille Cedex, France.|Aix-Marseille University, Marseille Cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011446:Prospective Studies; D015203:Reproducibility of Results; D012225:Rhinoplasty; D016896:Treatment Outcome; D055815:Young Adult
keywords: aesthetic analyses; facial and plastic surgery; nose; patient satisfaction; rhinoplasty; scale evaluation