{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:18:20Z","timestamp":1788326300701,"version":"build-2803163510"},"reference-count":8,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery & Aesthetic Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n Background:<\/jats:title>\n Rhinoplasty surgeons lack a universal scale of the relative difficulty of rhinoplasty techniques and rhinoplasty deformities.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To compare the expert opinion of the difficulty of rhinoplasty techniques and rhinoplasty deformities among international rhinoplasty surgeons, as measured by a scale of difficulty.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A cross-sectional survey of rhinoplasty surgeons collected training levels, experience, case volume, and perceived expertise. Rhinoplasty techniques\/deformities (\n n<\/jats:italic>\n = 64) were rated from 1\u201310, representing the least to most technically demanding. Rasch analysis was used to examine the fit of the observed data to Rasch model requirements, assess rating scale functioning, and provide estimates of internal consistency.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Respondents (\n n<\/jats:italic>\n = 63) were in practice (<5 years, 14%; 5\u201310, 20%; 10\u201320, 20%; 20\u201330, 26%; >30, 20%), and rhinoplasty volume ranged from <25 (14%) to >100 cases\/year (32%). Self-reported expertise was comfortably novice (32%), intermediate (10%), advanced (28%), and expert (30%). Otolaryngology (42%), facial plastic surgery (30%), and plastic surgery (28%) were represented. Rasch estimates of internal consistency reliability were excellent (0.96 for surgeons and 0.99 for items); the item difficulties were more heterogeneous (mean: 0, SD: 1.23) than the distribution of surgeons (mean: \u22120.09, SD: 0.58). Survey items were ordered by difficulty, ranging from least difficult (inferior turbinate reduction = 1.01) to most difficult (contracted nose repair post-infection = 8.24).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The newly developed Rhinoplasty Difficulty Scale provides ratings of common rhinoplasty techniques and deformities with a high correlation among experts using this rating scale.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/26893614261464778","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:25:31Z","timestamp":1784186731000},"page":"547-553","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rhinoplasty Difficulty Scale: Development and Psychometric Analysis of a Surgeon\u2019s Assessment of Rhinoplasty Technique and Nasal Deformity Correction"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6959-8475","authenticated-orcid":false,"given":"Dean M.","family":"Toriumi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rush University Medical School, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Everett V.","family":"Smith","sequence":"additional","affiliation":[{"name":"EVS Psychometric Services, LLC, Naperville, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7923-8115","authenticated-orcid":false,"given":"Miguel Gon\u00e7alves","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8658-8647","authenticated-orcid":false,"given":"Travis T.","family":"Tollefson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"15","key":"e_1_3_3_2_2","first-page":"103","article-title":"Rhinoplasty outcome measurement","volume":"6","author":"Hubin G","year":"2010","unstructured":"Hubin G, , Daele JJ. Rhinoplasty outcome measurement. B-ENT. 2010; 6,(Suppl 15):103\u2013108.","journal-title":"B-ENT"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/surgeries5030068"},{"key":"e_1_3_3_4_2","unstructured":"EBRRG. Evidence Based Rhinoplasty. Available from: https:\/\/www.evidenceinrhinoplasty.com\/ [Last accessed: December2 2021]."},{"key":"e_1_3_3_5_2","volume-title":"Probabilistic models for some intelligence and attainment tests","author":"Rasch G","year":"1960","unstructured":"Rasch G. (1960). Probabilistic models for some intelligence and attainment tests. Chicago: Mesa Press."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1163\/24689300-01401006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02293814"},{"key":"e_1_3_3_8_2","first-page":"202","volume-title":"Rasch measurement: Advanced and specialized applications","author":"Wolfe EW","year":"2007","unstructured":"Wolfe EW, , Smith EVJr. (2007a). Instrument development tools and activities for measure validation using Rasch models: Part I\u2014Instrument development tools. In Smith EV, & Smith RM (Eds.), Rasch measurement: Advanced and specialized applications (pp. 202\u2013242). Maple Grove, MN: JAM Press."},{"key":"e_1_3_3_9_2","first-page":"243","volume-title":"Rasch measurement: Advanced and specialized applications","author":"Wolfe EW","year":"2007","unstructured":"Wolfe EW, , Smith EVJr. (2007b). Instrument development tools and activities for measure validation using Rasch models: Part II\u2014Validation activities. In Smith EV, & Smith RM (Eds.), Rasch measurement: Advanced and specialized applications (pp. 243\u2013290). Maple Grove, MN: JAM Press."}],"container-title":["Facial Plastic Surgery & Aesthetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614261464778","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26893614261464778","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26893614261464778","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:25:06Z","timestamp":1788323106000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26893614261464778"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1177\/26893614261464778"],"URL":"https:\/\/doi.org\/10.1177\/26893614261464778","relation":{},"ISSN":["2689-3614","2689-3622"],"issn-type":[{"value":"2689-3614","type":"print"},{"value":"2689-3622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]}}}