Form Validation with NAFEQ-score of function and aesthetic results using paramedian forehead flap for nasal reconstruction

Background: Using paramedian forehead flap for nasal reconstruction is a standard method in reconstruction of nasal area. This procedure is usually performed at least in two steps. Although patients often react reluctant in the first moment, they are very pleased surprised about the endresults of the last reconstruction. Aesthetic and functional satisfaction of the patients after final healing has only subjective value. An objective evaluation is necessary for patients and surgeons and should be comparable.

Method: A new standardised Nasal Appearance and Function Evaluation Questionnaire (NAFEQ) was used, which was answered by 25 patients. Between 2006 and 2009 the questioned patients were operated for carcinoma of the nose and nasal reconstruction was performed by paramedian forehead flap. Results: Subjective assessment of function and satisfaction of older patients and of men was much more higher than in younger patients and women, whom evaluation is much differentiated. Satisfaction rises with time in retrospective view. Aesthetic results from surgeons point of view show only small differences to that of patients. Late evaluation by both, surgeons and patients, become similar.

Conclusion: Because subjective aesthetic evaluation from patients point of view is very difficult and the evaluation of surgical outcome has mostly a subjective character, standardised questionnaire is a must for objective assessment of the operation result. So the used questionnaire is a suitable way for objective evaluation of operational outcome.