A systematic review and meta-analysis of rhinoplasty using the rhinoplasty outcome evaluation scale

Background: The purpose was to evaluate the role and impact of the rhinoplasty outcome evaluation (ROE) in rhinoplasty. Objectives: To systematically review the ability of ROE to assess rhinoplasty outcome in the very recent surgical approaches. Data sources: Searching MESH terms "rhinoplasty" and "rhinoplasty and ROE" on PubMed, Scopus, Embase, Google Scholar, and other major literature databases. Study eligibility criteria: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses model was adopted for eligibility criteria. Participants and interventions: A first large screening on 1,660 papers allowed the final retrieval of 896 reports, of which only 101 were eligible for all the inclusion criteria, which allowed finally to select a group of 12 reports published in the time range 2018-2021. Study appraisal and synthesis methods: Meta-regression with Durbin-Watson test, checking of meta-analysis bias with Rosenthal's estimator, and heterogeneity through the I 2 statistics were performed. The analysis included a Mantel-Haenszel test and associated or meta-analysis. Results: Twelve eligible and qualified papers were included in the meta-analysis, out of 1,263 patients, from 1,660 papers. ROE confirmed previous reports about its ability to discriminate preoperative from postoperative outcome (50/100), as from the different rhinoplasty approaches, a value very close to the functional Nasal Obstruction Symptom Evaluation scale. This study strengthens the role of ROE in the evaluation of rhinoplasty outcomes encouraging further research to improve ROE scale on different cultural habits and geographical areas. Limitations: The main limitations were due to the weak inclusion and exclusion criteria, methodological flaws with the statistical analysis, and poor data synthesis and evaluation in many papers about ROE.