The Impact of Septorhinoplasty on Work Productivity and Activity Impairment: A Multi‐Institutional, Prospective Cohort

Abstract

OBJECTIVE: To evaluate the effect of septorhinoplasty on work productivity and activity impairment. STUDY DESIGN: Prospective cohort. SETTING: Four tertiary institutions. METHODS: Adults undergoing septorhinoplasty were administered surveys preoperatively and 3 to 8 months postoperatively. Preoperative and postoperative symptoms of nasal obstruction were measured with the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and Visual Analog Nasal Obstruction (VAS) scales. Work productivity and activity levels were measured using the Work Productivity and Activity Impairment Specific Health Problem (WPAI) survey. RESULTS: Among 212 patients, the average age was 42. 57% had allergic rhinitis, 22% had chronic sinusitis, and 22% had obstructive sleep apnea. The mean SCHNOS-O score was 74.1 ± 20.1 and VAS was 5.8 ± 2.7. 68.9% reported employment and missed an average of 1.5 ± 5.1 hours of work per week due to problems associated with nasal obstruction. On average, patients reported 32 ± 29% workplace impairment and 43 ± 29% daily activity impairment due to nasal obstruction. 94 underwent septorhinoplasty with improvement in SCHNOS-O (20.5 ± 18.2 vs 73.8 ± 19.1, P < .001) and VAS scores (1.5 ± 1.7 vs 5.6 ± 1.8, P < .001). Postoperatively, patients no longer missed work (0 ± 0.4 vs 2.1 ± 6.8 hours, P = .01), and significant improvements were seen in presenteeism (6.2 ± 15% vs 31 ± 27%, P < .001) and daily activity impairment (9.7 ± 18% vs 41 ± 25%; P < .001). CONCLUSIONS: Patients with moderate-severe nasal obstruction seeking septorhinoplasty report mild-moderate work impairment and moderate daily activity impairment as a direct result. Both work and daily activity impairment improve to minimal levels with surgical correction.