Download PDF
Facial Plast Surg 2018; 34(01): 095-101
DOI: 10.1055/s-0037-1615282
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Validation of the Modified Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) Questionnaire: A Prospective Analysis of Facial Plastic and Reconstructive Surgery Procedures

Jeremie D. Oliver
2   Mayo Clinic School of Medicine, Rochester, Minnesota
,
Deanna Menapace
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
,
Ahmed Younes
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
,
Chelsey Recker
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
,
Grant Hamilton
1   Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
,
Oren Friedman
3   Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
11 January 2018 (online)

Also available at
    Permissions and Reprints

Abstract

Although periorbital edema and ecchymosis are commonly encountered after facial plastic and reconstructive surgery procedures, there is currently no validated grading scale to qualify these findings. In this study, the modified “Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE)” questionnaire is used as a grading scale for patients undergoing facial plastic surgery procedures. This article aims to validate a uniform grading scale for periorbital edema and ecchymosis using the modified SPREE questionnaire in the postoperative period. This is a prospective study including 82 patients at two different routine postoperative visits (second and seventh postoperative days), wherein the staff and resident physicians, physician assistants (PAs), patients, and any accompanying adults were asked to use the modified SPREE questionnaire to score edema and ecchymosis of each eye of the patient who had undergone a plastic surgery procedure. Interrater and intrarater agreements were then examined. Cohen's kappa coefficient was calculated to measure intrarater and interrater agreement between health care professionals (staff physicians and resident physicians); staff physicians and PAs; and staff physicians, patients, and accompanying adults. Good to excellent agreement was identified between staff physicians and resident physicians as well as between staff physicians and PAs. There was, however, poor agreement between staff physicians, patients, and accompanying adults. In addition, excellent agreement was found for intraobserver reliability during same-day visits. The modified SPREE questionnaire is a validated grading system for use by health care professionals to reliably rate periorbital edema and ecchymosis in the postoperative period. Validation of the modified SPREE questionnaire may improve ubiquity in medical literature reporting and related outcomes reporting in future.

Keywords

edema - ecchymosis - periorbital - facial plastic surgery - reconstruction - rhinoplasty - browlift - facelift - blepharoplasty - facial fracture

Financial Disclosures

None.


 

  • References

  • 1 Ong AA, Farhood Z, Kyle AR, Patel KG. Interventions to decrease postoperative edema and ecchymosis after rhinoplasty: a systematic review of the literature. Plast Reconstr Surg 2016; 137 (05) 1448-1462
    CrossrefPubMedGoogle Scholar
  • 2 Kiliç C, Tuncel Ü, Cömert E, Şencan Z. Effect of the rhinoplasty technique and lateral osteotomy on periorbital edema and ecchymosis. J Craniofac Surg 2015; 26 (05) e430-e433
    CrossrefPubMedGoogle Scholar
  • 3 Fleiss JL. Statistical Methods for Rates and Proportions, 2nd ed. New York: John Wiley; 1981
    Google Scholar
  • 4 Griffies WS, Kennedy K, Gasser C, Fankhauser C, Taylor R. Steroids in rhinoplasty. Laryngoscope 1989; 99 (11) 1161-1164
    PubMedGoogle Scholar
  • 5 Gürlek A, Fariz A, Aydoğan H, Ersöz-Oztürk A, Evans GR. Effects of high dose corticosteroids in open rhinoplasty. J Plast Reconstr Aesthet Surg 2009; 62 (05) 650-655
    CrossrefPubMedGoogle Scholar
  • 6 Kara CO, Gökalan I. Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Plast Reconstr Surg 1999; 104 (07) 2213-2218
    CrossrefPubMedGoogle Scholar
  • 7 Yücel OT. Which type of osteotomy for edema and ecchymosis: external or internal?. Ann Plast Surg 2005; 55 (06) 587-590
    CrossrefPubMedGoogle Scholar
  • 8 Malay S, Chung KC. How to use outcomes questionnaires: pearls and pitfalls. Clin Plast Surg 2013; 40 (02) 261-269
    CrossrefPubMedGoogle Scholar
  • 9 Sears ED, Chung KC. A guide to interpreting a study of patient-reported outcomes. Plast Reconstr Surg 2012; 129 (05) 1200-1207
    CrossrefPubMedGoogle Scholar
  • 10 Moolenburgh SE, Mureau MA, Duivenvoorden HJ, Hofer SO. Validation of a questionnaire assessing patient's aesthetic and functional outcome after nasal reconstruction: the patient NAFEQ-score. J Plast Reconstr Aesthet Surg 2009; 62 (05) 656-662
    CrossrefPubMedGoogle Scholar
  • 11 Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg 2000; 24 (03) 192-197
    CrossrefPubMedGoogle Scholar
  • 12 Picavet V, Gabriëls L, Jorissen M, Hellings PW. Screening tools for body dysmorphic disorder in a cosmetic surgery setting. Laryngoscope 2011; 121 (12) 2535-2541
    CrossrefPubMedGoogle Scholar