Mr Henry Sharp
My Surgical Results
I see and treat patients with the whole range of ENT conditions, but functional and cosmetic surgery to the nose and sinuses forms around 90% of my surgical workload. The vast majority of these operations are for conditions that are not life-threatening but which significantly affect quality of life. For that reason, the best way to measure the success of this surgery is not survival rates but validated questionnaires that capture how a patient feels before and after their operation.
How I measure my results
To do this I use Patient Reported Outcome Measures (PROMs):
- SNOT-22 – for sinus surgery (Functional Endoscopic Sinus Surgery, or F.E.S.S.)
- SNOT-23 – for rhinoplasty (adds a question on how happy you are with the shape of your nose)
- ROE (Rhinoplasty Outcome Evaluation) – expressed as a satisfaction percentage
The most important aspect of these measurements is the change in score from before to after surgery. For SNOT-22, a change of 8.9 points (the Minimal Clinically Important Difference, or MCID) is needed for a patient to perceive a real improvement.
Sinus surgery (F.E.S.S.) results
| Patient group | Pre-op SNOT-22 | Post-op SNOT-22 | Improvement | % improvement |
|---|---|---|---|---|
| All patients | 52.85 | 15.12 | 37.23 | 71% |
| With polyps | 53.1 | 14.5 | 38.6 | 73% |
| Without polyps | 52.1 | 16.2 | 35.9 | 69% |
Compared with a 2015 UK survey of 2,263 patients from 87 hospitals, my improvement rate was 71% versus 40% in the UK series, and 88.3% of my patients achieved the MCID versus 66% in the UK series.
Rhinoplasty results
Average pre-operative SNOT-23 was 37 and average post-operative SNOT-23 was 13 – a 65% improvement.
| Metric | My series | UK series |
|---|---|---|
| Happy with outcome | 96% | 75% |
| Would repeat | 92% | 83% |
| Pre-op ROE | 32% | — |
| Post-op ROE | 79.15% | 73.3% |
| Improvement | 47% | — |
Auditing my results is an ongoing process, and I will continue to update this section as more data becomes available.
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References
- Hopkins C, Rudmik L, Lund VJ. The predictive value of the preoperative Sinonasal Outcome Test-22 score in patients undergoing Endoscopic Sinus Surgery for Chronic Rhinosinusitis. Laryngoscope 2015;125:1779–1784.
- Biggs TC, Fraser LR, Ward MJ, et al. Patient reported outcome measures in Septorhinoplasty surgery. Ann R Coll Surg Eng 2015;97:63–65.