Unilateral and Bilateral Effects of Nasal Septum Surgery Demonstrated with Acoustic Rhinometry, Rhinomanometry, and Subjective Assessment

Abstract

Little is known of what happens after an operative correction of nasal septum deviation in the cavity contralateral to the major septum deviation. We studied the effects of septoplasty on the objective and subjective unilateral and bilateral nasal airway in 117 consecutive patients presenting for septoplasty due to a clinically obstructing septum deviation. Significant median increases in nasal flow and cross-sectional areas were noted postoperatively on the deviation side, whereas on the contralateral side the nasal flow and the cross-sectional area at the nasal valve (MCA1) decreased significantly, the median decreases being 19% (p = 0.022) in the flow and 22% (p = 0.0001) in MCA1 before decongestion and correspondingly 22% (p = 0.004) and 21% (p = 0.0001) after decongestion. Only slight median increases were noted in the bilateral assessment postoperatively in these parameters. In the subjective assessment 40% of patients were totally free from nasal obstruction postoperatively and the sensation of obstruction was low in 35%. An inverse correlation was found between the postoperative satisfaction and the decrease in MCA1 on the wide side (r = -0.21, p = 0.03) and positive correlations between the postoperative satisfaction and the increase in MCA1 on the deviation side (r = 0.26, p = 0.0042) and with the bilateral increase in MCA1 (r = 0.20, p = 0.02). The preoperative subjective sensation of nasal obstruction correlated significantly with the objective parameters on the deviation side, but not with the bilateral parameters. In conclusion, it was demonstrated with an objective and subjective assessment that correction of a septum deviation may induce harmful effects to the valve area on the side contralateral to a deviation. However, postoperatively the overall relief of nasal obstruction was good and the satisfaction high in most patients.

Evaluation of operation success in patients with nasal septal deviation with quality of life scale and objective methods

“…Literatürdeki birçok çalışmada istatistiksel analizler, deviye tarafın verileri üzerinden ve nazal siklusun etkilerinden korunmak için dekonjesyon sonrası ölçümler kullanılarak yapılmıştır. [8][9][10][11][12][13][14][15][16] Çalışmamızda deviye tarafta hem dekonjesyon öncesi hem dekonjesyon sonrası, ameliyat sonrası MCA1, MCA2 değerleri ve hacim değerlerinde istatistiksel olarak anlamlı artış sağlandı ve bu sonucun literatürle uyumlu olduğu görüldü. [8][9][11][12][13][14][15][16] Truilhé ve Stoll [14] 102 hasta üzerinde yaptıkları çalışmada septoplasti sonrası dönemde MCA'da %26, hacimde %30 oranında artış saptanmıştır.…”

“…[8][9][10][11][12][13][14][15][16] Çalışmamızda deviye tarafta hem dekonjesyon öncesi hem dekonjesyon sonrası, ameliyat sonrası MCA1, MCA2 değerleri ve hacim değerlerinde istatistiksel olarak anlamlı artış sağlandı ve bu sonucun literatürle uyumlu olduğu görüldü. [8][9][11][12][13][14][15][16] Truilhé ve Stoll [14] 102 hasta üzerinde yaptıkları çalışmada septoplasti sonrası dönemde MCA'da %26, hacimde %30 oranında artış saptanmıştır. Kemker ve ark.nın [15] 1999 yılın-da yayınladığı bir çalışmada ise nazal cerrahinin nazal kavite üzerindeki etkisi akustik rinometriyle değerlendirilerek ameliyat sonrası dönemde hastaların deviye nazal kavitelerinin hacim ve kesit alan değerlerinde belirgin artış olduğunu göster-mişlerdir.…”

“…Bununla birlikte deviye olmayan nazal kavitenin ameliyat sonrası akustik rinometri sonuçları literatürde oldukça değişkendir. Pirilä ve Tikanto [8] ile Grymer ve ark. [9] tarafından yapılan iki ayrı çalışma sonucunda, deviye olmayan pasajda MCA değerlerinde istatistiksel olarak anlamlı düşme saptanmıştır.…”

Combining Spreader Grafts with Suture Suspension for Management of Narrow Internal Nasal Valve Angles

“…Previous studies have shown that either spreader grafts or lateral suspension technique alone may sometimes fail to improve nasal breathing in patients with dysfunctional nasal valves (17). Because most patients with nasal valve dysfunction actually have a combination of both narrow nasal valve angles together with weak upper lateral cartilages, tackling one side of the problem would not practically solve the breathing problem on a longterm basis.…”

Volumes nasais de adultos aferidos por rinometria acústica

“…Evidence also shows that these technical limitations do not invalidate the clinical usefulness of this method for posterior regions of the nasal cavity. The method may be employed in comparisons in the same subject, such as when investigating relative volume variations caused by velar movement in silent speech, [30][31][32] or to analyze variations caused by surgery (tonsillectomies, 33,34 septoplasty/turbinectomy 1,35,36 , or maxillomandubilar osteotomy 37,38 ), taking into account that systematic errors are common, that random errors may be minimized, and that measurements are reproducible in the same subject. 29 …”