Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate Cauterization for the Treatment of Nasal Obstruction using Objective and Subjective Methods

Abstract

Introduction Nasal septoplasty is considered the treatment of choice for nasal obstruction due to septal deviation. An ongoing discussion among rhinologists is whether it is reasonable to perform objective measurements of nasal patency pre or postoperatively routinely. Objective The primary aim of this study was to identify the short- and long-term functional benefits for patients undergoing septal surgery, as assessed by acoustic rhinometry (AR). The secondary goal was to evaluate the short- and long-term perception of symptom relief and disease-specific quality of life (QoL) outcomes on the part of the patients. Methods This was a prospective observational study in which AR was utilized for the assessment of nasal patency preoperatively and 1, 6 and 36 months after septoplasty. Total 40 patients who underwent septoplasty filled out the Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire and the Glasgow Benefit Inventory (GBI) to assess their subjective improvement in nasal obstruction symptoms and the changes in their QoL. Results There were statistically significant improvements in nasal patency, mean postoperative NOSE and GBI scores postoperatively. However, there was no correlation between the mean NOSE and GBI scores and the AR measurements. Furthermore, the GBI scores tended to decrease as the postoperative period increased. Conclusion The present study confirms that septoplasty significantly increases nasal patency and causes a significant subjective improvement in nasal obstruction symptoms. The absence of a statistically significant correlation among the objective measurements, the symptom scores, and the patients' low GBI scores indicates that factors other than the anatomical findings may also contribute to the patients' perception of QoL.

A prospective, non-randomized evaluation of a novel low energy radiofrequency treatment for nasal obstruction and snoring

“…From the literature, it is apparent that there is, as yet, no objective measuring instrument which provides reproducible results regarding the degree and nature of nasal obstruction or which closely correlated with both patient sensations of breathing and the results of macroscopic and endoscopic examinations [ 31 ]. In the literature, large differences are reported between objective and subjective measurements of nasal obstruction [ 32 – 34 ].…”

The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation

“…2,[4][5][6] Nasal septoplasty is the standard treatment of nasal septal deviation because it usually produces an improvement of nasal airflow and resolution of nasal obstruction symptoms. [7][8][9][10] To date, there are a few studies evaluating the effects of septal surgery on olfactory function. 1,[11][12][13][14][15][16][17][18] However, the impact of olfactory impairment due to septal deviation on the nasal-symptom related and general QoL of the patients has not been adequately addressed in the literature.…”

Why Does General QoL Tend to Worsen Over Time Following Septoplasty Even in the Absence of Worsening Nasal Symptoms?

“…Sometimes after a septoplasty the deviation can persist. Surprisingly, some persistent septal deviations are associated with patient's satisfaction and good QoL, whereas completely restored deviations are not [1,5] Although previous studies have already investigated assessment, outcomes, clinical implications and patients' satisfaction after primary septoplasty, most publications suffered from various limitations in design. Many of them were based on different surgical techniques, used only telephone follow-up surveys, relied on physician-rated outcomes rather than patient assessments of outcome, or applied either not validated outcome measures or validated outcome measures not specifically designed for nasal obstruction.…”