Daily Cosmetic Research Analysis
Analyzed 14 papers and selected 3 impactful papers.
Summary
Across musculoskeletal and craniofacial surgery, and endocrine surgery, three studies stand out: a secondary analysis from a randomized trial defines minimal clinically important changes for surface topography in adolescent idiopathic scoliosis; a prospective cohort questions the applicability of body dysmorphic disorder screening tools in orthognathic surgery; and a national database study quantifies the substantial morbidity and economic burden of vocal fold paralysis after thyroidectomy.
Research Themes
- Patient-centered outcome measurement and cosmetic perception in scoliosis
- Psychological screening validity in orthognathic (aesthetic) surgery
- Complication-associated resource utilization in endocrine surgery
Selected Articles
1. Responsiveness and minimal clinically important changes of surface topography parameters in adolescents with idiopathic scoliosis: results from the schroth exercise trial.
Secondary analysis of a randomized trial (n=124) established MCIC thresholds for surface topography asymmetry metrics (RMS and MaxDev) that align with patient-reported global improvement after 6 months of Schroth exercises. Correlations with perceived change were moderate (RMS r=-0.510; MaxDev r=-0.409), with stronger discrimination in lumbar curves (e.g., RMS AUC 0.881).
Impact: Defines patient-anchored, radiation-free cosmetic/shape change thresholds for AIS, enabling responsive outcome assessment beyond Cobb angle. This supports clinically meaningful, patient-centered monitoring and trial endpoints.
Clinical Implications: Clinicians can use ST-based MCIC thresholds to interpret whether observed changes reflect meaningful cosmetic/postural improvement, especially for lumbar curves, informing therapy adjustments and shared decision-making.
Key Findings
- GRC correlated with changes in RMS (r=-0.510, p<0.001) and MaxDev (r=-0.409, p<0.001).
- Participants reporting improvement had mean decreases of 1.76±2.9 mm (RMS) and 3.29±6.5 mm (MaxDev); those without improvement worsened slightly.
- ROC-derived MCICs: overall RMS -0.27 mm (AUC 0.746), MaxDev -0.49 mm (AUC 0.717); meeting both yielded 62% sensitivity and 74% specificity.
- Lumbar curves showed stronger discrimination (RMS AUC 0.881; MaxDev AUC 0.811) than thoracic curves.
Methodological Strengths
- Secondary analysis of randomized controlled trial with standardized Schroth protocol
- Anchor-based approach using patient-reported Global Rating of Change
- Robust discrimination via ROC analyses with subgroup evaluation by curve type
Limitations
- Secondary analysis may inherit selection and protocol limitations of the parent RCT
- Six-month follow-up limits assessment of long-term maintenance of cosmetic change
- Thoracic curve discrimination was modest, potentially limiting generalizability
Future Directions: External validation of MCIC thresholds, linkage to long-term functional and quality-of-life outcomes, and integration with patient-reported cosmetic measures are warranted.
INTRODUCTION: Adolescent idiopathic scoliosis (AIS) affects 2-3% of adolescents, causing spinal curvature and functional limitations. Traditional assessment using the Cobb angle may only partially capture patient concerns about aesthetics. The Schroth scoliosis-specific exercises (SSE), focusing on posture correction, have shown promise for reducing the Cobb angle and preventing progression, though research on its cosmetic impact is limited. Surface topography (ST) offers a radiation-free alternat
2. Body dysmorphic disorder in patients undergoing orthognathic surgery: associations and applicability of screening tools.
In a prospective cohort of 100 orthognathic patients, 10% screened positive on the BDDQ, associated with female sex and higher AAI scores, but none were clinically diagnosed with BDD upon psychiatric evaluation. No postoperative aesthetic complaints were reported, suggesting limited applicability and specificity of current BDD screening tools in this population.
Impact: Challenges the routine reliance on BDD screening tools in orthognathic candidates by demonstrating high false-positive rates, thereby informing preoperative psychological assessment strategies.
Clinical Implications: Use BDD screening judiciously and in conjunction with comprehensive clinical interviews; prioritize targeted psychiatric referral based on multidimensional assessment rather than screening positivity alone, with attention to sex-related differences.
Key Findings
- 10% of patients screened positive on BDDQ; positivity associated with female sex (P<0.0001) and higher AAI scores (P<0.0001).
- No significant associations with age, psychiatric history, skeletal relationship, overjet, overbite, or OHIP-14 scores.
- None of the screen-positive patients were diagnosed with BDD on formal psychiatric evaluation.
- No postoperative aesthetic complaints were reported in the cohort.
Methodological Strengths
- Prospective cohort design with standardized screening (BDDQ, AAI, OHIP-14)
- Psychiatric referral for diagnostic confirmation minimized misclassification
- Analysis of clinical correlates including dentofacial parameters
Limitations
- Single-center cohort with modest sample size (n=100) limits generalizability
- Screening tools not validated specifically for East Asian orthognathic populations
- Follow-up duration for postoperative complaints not detailed
Future Directions: Develop and validate culturally and procedurally specific BDD screening instruments; incorporate longitudinal assessments to evaluate predictive validity for postoperative satisfaction and mental health.
The study aimed to evaluate the prevalence and associations of body dysmorphic disorder (BDD) in East Asian patients undergoing orthognathic surgery, and the applicability of current BDD screening tools for these patients. A prospective cohort study was conducted involving patients presenting for orthognathic surgery. Data on their preoperative and postoperative complaints, age, gender, psychiatric history, skeletal classification, overjet and overbite were collected. Patients completed three
3. Short-term Clinical and Economic Outcomes Associated with Vocal Fold Paralysis in Adults Undergoing Thyroidectomy: Analysis of the National Readmissions Database, 2016-2020.
Among 33,360 thyroidectomy patients, VFP was associated with longer length of stay (+3.61 days) and higher hospital charges (+USD 45,700), increased risks of multiple complications, and higher 30- and 90-day readmissions, without differences in in-hospital mortality, after 1:4 propensity score matching.
Impact: Provides large-scale, adjusted estimates of the morbidity and economic burden attributable to VFP, informing risk counseling, quality improvement, and resource planning.
Clinical Implications: Emphasizes the need for preventive strategies (e.g., nerve monitoring, surgical expertise), early detection and management pathways for VFP, and targeted follow-up to reduce readmissions and complications.
Key Findings
- VFP associated with increased LOS (+3.61 days; 95% CI: 3.06–4.17) and higher hospital charges (+USD 45,700; 95% CI: 38,120–53,280), p<0.001.
- Higher odds of multiple complications with VFP, including dysphagia, dysphonia, pneumonia, UTI, respiratory failure/mechanical ventilation, AKI, bleeding/hemorrhage, and nervous system complications.
- Increased 30-day and 90-day readmissions (including unplanned) with VFP; no difference in in-hospital mortality.
Methodological Strengths
- Large national database with 33,360 cases and 1:4 propensity score matching
- Comprehensive assessment of both clinical complications and economic outcomes
- Adjustment for baseline characteristics improves internal validity
Limitations
- Retrospective database design subject to coding errors and residual confounding
- Lack of granular clinical detail (e.g., nerve monitoring use, surgeon volume) limits causal inference
- Short-term outcomes; long-term voice and quality-of-life impacts not assessed
Future Directions: Prospective registries incorporating operative details and standardized voice outcomes could identify modifiable risk factors and evaluate targeted interventions to reduce VFP burden.
OBJECTIVE: Vocal fold paralysis (VFP) is a complication of thyroidectomy associated with postoperative morbidity. However, its short-term clinical and economic effects remain underexplored. This study aimed to evaluate short-term clinical and economic outcomes associated with VFP in adults undergoing thyroidectomy. METHODS: This retrospective cohort study included adults ≥18 years who underwent thyroidectomy between 2016 to 2020, using data from the Nationwide Readmissions Database. Patients were