Outcomes after Nasal Septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) Study

Abstract

OBJECTIVE: Our goal was to assess disease-specific quality of life outcomes after nasal septoplasty in adults with nasal obstruction.

DESIGN, SETTINGS, AND PATIENTS: We conducted a prospective observational outcomes multicenter study with 14 sites and 16 investigators, including private practice and academic settings. Patients had had septal deviation and symptomatic nasal obstruction for at least 3 months, and medical management had failed.

METHODS: Patients with septal deviation completed a validated outcomes instrument (the Nasal Obstruction Septoplasty Effectiveness (NOSE) scale) before and 3 and 6 months after septoplasty, with or without partial turbinectomy.

RESULTS: Fifty-nine patients underwent surgery; there was a significant improvement in mean NOSE score at 3 months after septoplasty (67.5 versus 23.1, P < 0.0001), and this improvement was unchanged at 6 months. Patient satisfaction was very high, and patients used significantly fewer nasal medications.

CONCLUSIONS: In patients with septal deformity, nasal septoplasty results in significant improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use. (Otolaryngol Head Neck Surg 2004;130:283–90.)

Get full access to this article

View all access options for this article.

References

Jessen

Ivarsson

Malm

Nasal airway resistance and symptoms after functional septoplasty: Comparison of findings at 9 months and 9 years. Clin Otolaryngol 1989;14:231–4.

Siegel

Gliklich

Taghizadeh

Outcomes of septoplasty. Otolaryngol Head Neck Surg 2000;122:228–32.

Stewart

Robinson

Wilson

Assessment of patient's benefit from rhinoplasty. Rhinology 1996;34:57–9.

Samad

Stevens

Maloney

The efficacy of nasal septal surgery. J Otolaryngol 1992;21:88–91.

Arunachalam

Kitcher

Gray

Nasal septal surgery: Evaluation of symptomatic and general health outcomes. Clin Otolaryngol 2001;26:367–70.

Broms

Jonson

Malm

Rhinomanometry, IV: A pre-and postoperative evaluation in functional septoplasty. Acta Otolaryngol 1982;94:523–9.

Damm

Quante

Jungehuelsing

Impact of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhinosinusitis. Laryngoscope 2002;112:310–5.

Hwang

McLaughlin

Lanza

Endoscopic septoplasty: Indications, technique, and results. Otolaryngol Head Neck Surg 1999;120:678–82.

Pirila

Tikanto

Unilateral and bilateral effects of nasal septum surgery demonstrated with acoustic rhinometry, rhinomanometry, and subjective assessment. Am J Rhinol 2001;15:127–33.

10.

Passali

Anselmi

Lauriello

Treatment of hypertrophy of the inferior turbinate: Long-term results in 382 patients randomly assigned to therapy. Ann Otol Rhinol Laryngol 1999;108:569–75.

11.

Katz

Schmelzer

Vidts

Treatment of the obstructive nose by CO2-laser reduction of the inferior turbinates: Technique and results. Am J Rhinol 2000;14:51–5.

12.

Stewart

Witsell

Smith

Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngol Head Neck Surg 2003 (in press).

13.

Guyatt

Osoba

Methods to explain the clinical significance of health status measures. Mayo Clin Proc 2002;77:371–83.

14.

Juniper

Guyatt

Development and testing of a new measure of health status for clinical trials in rhino-conjunctivitis. Clin Exp Allergy 1991;21:77–83.

15.

Jessen

Malm

The importance of nasal airway resistance and nasal symptoms in the selection of patients for septoplasty. Rhinology 1984;22:157–64.

16.

McKee

O'Neill

Roberts

Nasal airflow after septorhinoplasty. Clin Otolaryngol 1994;19:254–7.

17.

Powell

Zonato

Weaver

Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: A randomized, double-blind, placebo-controlled clinical pilot trial. Laryngoscope 2001;111:1783–90.

18.

Benninger

Senior

The development of the Rhinosinusitis Disability Index. Arch Otolaryngol Head Neck Surg 1997;123:1175–9.

19.

Piccirillo

Merritt

Richards

Psychometric and clinimetric validity of the 20-item Sino-Nasal Outcome Test (SNOT-16). Otolaryngol Head Neck Surg 2002;126:41–7.

20.

Gliklich

Metson

Techniques for outcomes research in chronic sinusitis. Laryngoscope 1995;105:387–90.

21.

Kemker

Corey

Branca

Development of the Allergy Outcome Survey for allergic rhinitis. Otolaryngol Head Neck Surg 1999;121:603–5.

22.

Rhee

Book

Burzynski

Quality of life assessment in nasal airway obstruction. Laryngoscope 2003;113:1118–22.