Evaluation of the severity of disease and the effectiveness of operative treatment is commonly done by registering pre- and postoperative symptoms. During the preceding decade, greater awareness has focused not only on the symptoms but also on patients' quality of life (QoL). The aim of the study was to determine the effect of septoplasty, as measured by generic and disease-specific QoL questionnaires. The generic 15D and disease-specific SNOT-22 questionnaires were given to patients before the operation and 6 months after the operation. Data analysis consisted originally of 188 septoplasty patients. One-hundred and twenty-six patients (67%) answered the SNOT-22 questions, and in the 15D, the response rate was 76%. In the post-operative SNOT-22, the need to blow the nose, sneezing, runny nose, nasal obstruction, loss of smell or taste, post-nasal discharge, facial pain/pressure, difficulty in falling asleep and waking up at night improved significantly. However in the 15D the mean QoL, i.e., general well-being, became significantly poorer. The QoL became increasingly poor especially in the older age groups and among the patients in which the improvement achieved in nasal symptoms postoperatively was minor. The more nasal symptoms the patients had pre- or postoperatively, the poorer the QoL was in general. Based on our results, critical evaluation of the symptoms and findings in the patients is essential in deciding whether surgery or other treatment should be given to individual patients having nasal blockage symptoms. Especially in patients with mild symptoms or among older patients, adequate medical treatment has to be tried before even considering surgery. The results also encourage the use of a systematic questionnaire to estimate the severity of symptoms in daily clinical practice.

. Septoplasties can be performed under local anaesthesia. However, careful prevention and treatment of pain during the operation is essential. . Septoplasties are suitable operations for short-stay surgery. .Two-years post-operative, septoplasty relieved the symptoms well or excellently in 55% and moderately in 27% of the cases. . Specialists prescribe more prophylactic antibiotics than residents (47%versus 29%P = 0.02). .Post-operative antibiotics do not appear to prevent the development of post-operative infections.

BACKGROUND: Prophylactic antibiotics are often used in septoplasty. However, the number of controlled studies, especially randomized double blind placebo controlled studies on the effect of antibiotics in septum surgery, is very low. The PURPOSE OF THE PRESENT STUDY was to investigate if intravenous cefuroxime given as preoperative antimicrobial prophylaxis 30 minutes prior to surgery diminishes the risk of infection after septoplasty during the first postoperative month among patients with normal immune function. METHODS: This study was a double-blind placebo controlled randomized study and patients were randomized to either an antibiotic prophylaxis-group or placebo-group. RESULTS: In the antibiotic-group, the infection rate was 2.2% (2/92) and in the placebo-group 8.3% (8/96), which is not statistically different. All three deep incisional SSI (septal abscess) occurred in the placebo-group. The preoperative crusting or purulent secretion, or Staphylococcus aureus in the bacterial swab increased the risk of postoperative infection significantly. CONCLUSIONS: We recommend the use of one dose of 1500 mg intravenous cefuroxime prior to septoplasty in patients having crusts or purulent secretion in the nasal cavities or if the operation is expected to be prolonged.

Objectives The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting Tertiary rhinology centers. Methods Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001–17 were studied. Mean follow-up time was 9.9 years (range 1.1–15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean ± SD of 4.3 ± 2.8 and 3.7 ± 2.6 years, respectively (p = .013, by Logrank test). In Cox´s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.