Predictors of Long‐Term Nasal Obstruction Symptom Evaluation Score Stability Following Septoplasty With Inferior Turbinate Reduction

Abstract

Objectives/Hypothesis Determine the postoperative Nasal Obstruction Symptom Evaluation (NOSE) score stability between 1 and ≥6 months after septoplasty with inferior turbinate reduction (ITR). Education level and occupation were evaluated to determine their effects on NOSE score stability during the postoperative period. Study Design Retrospective case series. Methods This was a retrospective case series. Patients were included if they underwent septoplasty with ITR for nasal obstruction due to septal deviation and inferior turbinate hypertrophy. NOSE scores were collected preoperatively, and at 1 and ≥6 months postoperatively. Education level and occupation were collected postoperatively via telephone survey. Changes in NOSE scores were compared between the different time points. Education level and occupation were analyzed to determine if they affected NOSE scores. Results There were 98 patients included, and 56 were male (57.1%). Mean NOSE scores preoperatively and at 1 and ≥6 months postoperatively were 72.1, 17.1, and 12.0, respectively. Patients demonstrated a statistically and clinically significant reduction in NOSE score at 1 month (−54.9, P < .001) and at ≥6 months postoperatively (−60.0, P < .001). The mean 6.2‐point decrease in NOSE score from 1 to ≥6 months was statistically, but not clinically significant. There were no significant differences in NOSE score changes based on educational level and occupation. Conclusions Patients achieved statistically and clinically significant reductions in NOSE scores at 1 months, with no clinically significant differences in NOSE scores at ≥6 months, suggesting NOSE score stability between these postoperative time points. Neither education level nor occupation influenced NOSE scores. Level of Evidence 4 Laryngoscope, 131:E2105–E2110, 2021

Quality of Life and Symptoms Before and After Nasal Septoplasty With or Without Turbinoplasty Compared With Control Individuals in Saudi Arabia

“…The mean postoperative score reflected mild symptoms on NOSE score scale, although it remained higher than the mean score of the control group, suggesting that nasal septoplasty resulted in improved disease-specific quality of life. This finding is consistent with previous studies reporting significant reductions in NOSE scores and improvements in disease-specific quality of life after nasal septoplasty with or without turbinate reduction 10,16–19. Likewise, a recent study assessing the outcomes of nasal septoplasty in 51 patients using NOSE scores found significant improvements in nasal obstruction 3 and 7 months postoperatively.…”

“…This finding is consistent with previous studies reporting significant reductions in NOSE scores and improvements in disease-specific quality of life after nasal septoplasty with or without turbinate reduction. 10 , 16 – 19 Likewise, a recent study assessing the outcomes of nasal septoplasty in 51 patients using NOSE scores found significant improvements in nasal obstruction 3 and 7 months postoperatively. The mean preoperative and 3- and 7-month postoperative NOSE scores were 60.3±20.4, 32.9±16.8, and 39.6±33.2, respectively.…”

“…However, several studies have shown no significant changes in NOSE scores between 3 and 6 postoperative months 10,17,33. Another study found no clinically significant differences in NOSE scores between 1 and 6 postoperative months and concluded that follow-up may not be required after the first postoperative month 19. Although there are many studies on the nasal septoplasty, however, criteria for diagnosis and evaluation have many subjective contents, in addition to surgeon experience, which may increase the variability between studies.…”

Translation and validation of the Bahasa Malaysia version of the Nasal Obstruction Symptom Evaluation scale (M-NOSE)

“…The responsiveness and stability of NOSE allow the surveillance of symptom change over time. The use of NOSE demonstrated significant reduction of nasal obstruction was achieved at 1 month following septoplasty and turbinate reduction with the status quo remains unchanged at 6 months ( Law et al, 2021 ). A reliable postoperative evaluation is necessary as burden of disease varies from patient to patient and identification of problematic cases allows individualized management ( Gerecci et al, 2019 ).…”

Surgical Correction of Nasal Obstruction and Its Effect on Eustachian Tube Dysfunction Symptoms

“…Also, our retrospective design was susceptible to significant loss to follow‐up, as was encountered in our study at later timepoints of 3 and 6 months. Law et al recently showed that nasal obstruction symptoms do not significantly change postoperatively between 1 and 6 months, 22 suggesting that ETD symptom improvement after surgery for nasal obstruction may also be sustained across these timepoints. It is possible that our study underestimates long‐term improvements in nasal obstruction and ETD symptoms through selection bias, as patient visits at later timepoints may have been less likely to continue if symptoms had resolved.…”