Surendrakumar and Sukhen Nasal After Rhinoplasty Evaluation Score (SSNARES): An Innovative Leap in Rhinoplasty Outcome Analysis.

Abstract

Objectives: The nose is the most prominent part of the face. The postoperative evaluation of the nose is vital to check if the desired surgical result was achieved. The scarcity of standardized scales/scores for nasal assessment inspired us to develop an entirely new scoring system (Surendrakumar and Sukhen Nasal After Rhinoplasty Evaluation Score [SSNARES]), which is universally applicable to people of all ethnic groups, ages, and genders, and yields a valid, reliable result.

Methods: SSNARES consists of a questionnaire of 10 parameters that assesses the nose aesthetically, functionally, and psychologically. Patient's responses are graded between 0-4 scores per parameter. The addition of all scores yields the final score, which is correlated with a satisfaction grade (a quantitative measure of patient satisfaction after surgery). SSNARES was thoroughly analyzed by an interdisciplinary panel of experts and underwent stringent statistical analysis to prove its validity and reliability upon pilot testing on 20 patients.

Results: The item content validity index and score content validity index of SSNARES were both 1 (excellent). Bartlett's Test of Sphericity showed a p-value of <0.001, indicating a highly significant test. The Kaiser-Meyer-Olkin test value for the overall score is >0.9 (marvelous category). The construct validity of SSNARES was tested by exploratory factor analysis, and questions with loadings >0.4 were considered significant to represent a specific factor. The confirmatory factor analysis of SSNARES showed a p-value of <0.001, indicating a high significance level and strong correlation. The Cronbach's α coefficient of SSNARES is 0.9646, which highlights excellent reliability.

Conclusions: This cost-effective, efficient, easy-to-use, patient-oriented new score will be of prime significance for patients, clinicians, and researchers for score computation, decision-making for reintervention, and research purposes.