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

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.

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Preoperative and Postoperative Nasal Septal Surgery Assessment with Acoustic Rhinometry

Otolaryngology ◽

10.1016/s0194-5998(97)70123-2 ◽

1997 ◽

Vol 117 (4) ◽

pp. 338-342 ◽

Cited By ~ 22

Author(s):

Larry Shemen ◽

Richard Hamburg

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Acoustic Rhinometry ◽

Nasal Fossa ◽

Indications For Surgery ◽

Subjective Improvement ◽

Nasal Patency ◽

Deviated Nasal Septum ◽

Postoperative Assessment ◽

Septal Surgery

INTRODUCTION: Acoustic rhinometry is a relatively new tool used for the measurement of the geometry of the nasal fossa. We hypothesized that acoustic rhinometry would be useful for preoperative and postoperative assessment of patients undergoing septal surgery. METHODS AND MATERIAL: Twenty-four patients undergoing septal surgery performed by two surgeons underwent preoperative and postoperative rhinometry. The indications for surgery were nasal obstruction caused by a deviated nasal septum. Rhinometry was conducted with the Eccovision Acoustic Rhinometry System (Hood Laboratories). Analysis of the data was performed with the Kwikstat program (Texasoft) and Excel (Microsoft). RESULTS: Subjective improvement in nasal patency was significantly correlated with improvement in acoustic rhinometry. CONCLUSIONS: Acoustic rhinometry is valuable in objectively confirming nasal patency after nasal septal and turbinate surgery.

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Objective Assessment of Nasal Patency

Facial Plastic Surgery ◽

10.1055/s-0037-1604356 ◽

2017 ◽

Vol 33 (04) ◽

pp. 378-387 ◽

Cited By ~ 2

Author(s):

Aristeidis Giotakis ◽

Peter Tomazic ◽

Herbert Riechelmann ◽

Julia Vent

Keyword(s):

Nasal Obstruction ◽

Surgical Outcomes ◽

Clinical Relevance ◽

Objective Assessment ◽

Nasal Airflow ◽

Nasal Patency ◽

Review Of The Literature ◽

Objective Measurements

AbstractThe aim to objectify nasal airflow and patency is ongoing—many methods have been suggested, often lacking clinical relevance or showing weak correlations with patients' symptoms. It is crucial to thoroughly consult our patients presenting with nasal obstruction—and to inform them about realistic possible surgical outcomes. Often, a perfect-looking internal nose with a straight septum and normal-appearing turbinates does not guarantee a happy, symptom-free “owner.” A review of the literature and the current technical market is presented here to facilitate the rhinosurgeon's decision to perform pre- and postoperative objective measurements of nasal airflow. Recommendations by the societies have been included.

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Unilateral and Bilateral PNIF in Quality Control of Nasal Septal Surgery

International Journal of Otolaryngology ◽

10.1155/2018/7846843 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Liv Kari Døsen ◽

Knut Kvinnesland ◽

Magnus TarAngen ◽

Olga Shiryaeva ◽

Caryl Gay ◽

...

Keyword(s):

Quality Control ◽

Visual Analogue Scale ◽

Nasal Obstruction ◽

Analogue Scale ◽

Inspiratory Flow ◽

Septal Surgery ◽

Vas Scores ◽

Nasal Septoplasty ◽

Results Of Surgery ◽

Peak Nasal Inspiratory Flow

The aim of this study was to explore the usefulness of unilateral, combined unilateral (left + right), and bilateral peak nasal inspiratory flow (PNIF) measurements in assessing the results of nasal septal surgery. Nasal obstruction was recorded subjectively and objectively before and 4 months after nasal septoplasty using a visual analogue scale (VAS) and a PNIF meter. Nasal septoplasty (58 patients) and septoplasty with turbinoplasty (68 patients) were performed on 126 patients (85 males; 41 females) with a mean age of 32.8 years. The results showed a significant improvement in VAS scores, as well as unilateral, combined unilateral, and bilateral PNIF values after both septoplasty and septoplasty with turbinoplasty. Septoplasty with turbinoplasty showed better improvement in VAS and PNIF scores than septoplasty alone and this was significant for bilateral PNIF scores. The best unilateral pre- and postoperative correlations between VAS and PNIF measurements were found using the lower of the two unilateral PNIF scores, irrespective of side. In the total material, VAS/PNIF correlations were mostly significant, but weak (all r<0.30). We found VAS and PNIF to be useful instruments in reporting results of surgery. The weak correlations between VAS and PNIF measurements suggest that these subjective and objective instruments may target different aspects of nasal obstruction.

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Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy

Obstetrics and Gynecology International ◽

10.1155/2015/967568 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 13

Author(s):

Michael C. Pitter ◽

Serene S. Srouji ◽

Antonio R. Gargiulo ◽

Leslie Kardos ◽

Usha Seshadri-Kreaden ◽

...

Keyword(s):

Symptom Relief ◽

Laparoscopic Myomectomy ◽

Robot Assisted ◽

Retrospective Survey ◽

Factors Associated ◽

Caucasian Race ◽

The Us ◽

Short And Long Term ◽

Symptom Recurrence

Objective. To examine success of robot-assisted laparoscopic myomectomy (RALM) measured by sustained symptom relief and fertility.Methods. This is a retrospective survey of 426 women who underwent RALM for fibroids, symptom relief, or infertility at three practice sites across the US. We examined rates of symptom recurrence and pregnancy and factors associated with these outcomes.Results. Overall, 70% of women reported being symptom-free, with 62.9% free of symptoms after three years. At >3 years, 66.7% of women who underwent surgery to treat infertility and 80% who were also symptom-free reported achieving pregnancy. Factors independently associated with symptom recurrence included greater time after surgery, preoperative dyspareunia, multiple fibroid surgeries, smoking after surgery, and preexisting diabetes. Factors positively correlated with achieving pregnancy included desiring pregnancy, prior pregnancy, greater time since surgery, and Caucasian race. Factors negatively correlated with pregnancy were advanced age and symptom recurrence.Conclusions. This paper, the first to examine symptom recurrence after RALM, demonstrates both short- and long-term effectiveness in providing symptom relief. Furthermore, RALM may have the potential to improve the chance of conception, even in a population at high risk of subfertility, with greater benefits among those who remain symptom-free. These findings require prospective validation.

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Nasal Surgery in the Management of Sleep Apnea

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948509400605 ◽

1985 ◽

Vol 94 (6) ◽

pp. 550-554 ◽

Cited By ~ 54

Author(s):

Vijay S. Dayal ◽

Eliot A. Phillipson

Keyword(s):

Sleep Apnea ◽

Subjective Improvement ◽

Nasal Valve ◽

Nasal Surgery ◽

Obstructive Sleep ◽

Short And Long Term ◽

Objective Improvement ◽

Valve Area

We present our experience with short- and long-term beneficial results obtained from surgery of the nasal valve area in carefully selected patients with obstructive sleep apnea (OSA). In six cases reported here, surgical treatment resulted in subjective improvement in snoring and daytime somnolence. Objective improvement was noted in three patients who had nasal valve area obstruction. Although the role of surgery in patients with mild OSA needs further assessment, surgical correction of nasal valve area obstruction in patients with moderately severe to severe OSA appears clearly indicated.

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Evaluation of non-response in quality control of nasal septal surgery

The Journal of Laryngology & Otology ◽

10.1017/s002221511600921x ◽

2016 ◽

Vol 130 (12) ◽

pp. 1130-1136 ◽

Cited By ~ 2

Author(s):

M T Egeland ◽

M Tarangen ◽

C Gay ◽

L K Døsen ◽

R Haye

Keyword(s):

Quality Control ◽

Visual Analogue Scale ◽

Nasal Obstruction ◽

Analogue Scale ◽

Response Rates ◽

Electronic Version ◽

Visual Analogue Scales ◽

Septal Surgery ◽

Analogue Scales ◽

Nasal Septoplasty

AbstractObjective:Questionnaires are often used to assess the results of nasal septoplasty, but response rates vary widely. The possible bias caused by non-responders was evaluated to determine the validity of questionnaire results.Methods:Post-operative questionnaires employing visual analogue scales for nasal obstruction were mailed to 182 patients. The 62 non-responders (34.1 per cent) were contacted by telephone, 58 (93.5 per cent) of whom were contactable and responded orally to the questionnaire.Results:Non-responders were younger, but no different from responders with regard to gender, smoking habits or allergies. Post-operative visual analogue scale obstruction scores were slightly, but not statistically, higher in non-responders. However, because non-responders’ pre-operative scores were lower, obstruction scores improved less than in responders. The main reason for not responding was forgetfulness. Some would have preferred an electronic version of the questionnaire.Conclusion:Although post-operative obstruction scores did not differ between the groups, nasal obstruction scores improved more among responders than non-responders. Thus, low response rates may cause bias.

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Evaluation of the Nasal Surgical Questionnaire for Monitoring Results of Septoplasty

International Journal of Otolaryngology ◽

10.1155/2015/563639 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Rolf Haye ◽

Magnus Tarangen ◽

Olga Shiryaeva ◽

Liv Kari Døsen

Keyword(s):

Normal Population ◽

Substantial Improvement ◽

Nasal Symptoms ◽

Vas Scores ◽

Short And Long Term ◽

The Mean ◽

Analogue Scales ◽

Nasal Septoplasty ◽

Results Of Surgery

Monitoring the results of surgery is important. The otorhinolaryngology department of our hospital currently uses preoperative and postoperative versions of the Nasal Surgical Questionnaire (NSQ) for continuous evaluation of nasal septoplasty. In this study, 55 patients undergoing septoplasty answered the preoperative version twice to assess the NSQ’s test-retest precision, and 75 patients answered the preoperative questionnaire before and the postoperative one 6 months after surgery to evaluate the NSQ’s ability to detect change in symptoms following surgery. Both the pre- and postoperative versions of the NSQ use separate visual analogue scales (VAS) to assess nasal obstruction during the day, at night, and during exercise. Other nasal symptoms are graded as secondary outcomes using 4-point Likert scales. The mean VAS scores for the two preoperative obstruction ratings were not significantly different. The scores were significantly higher than in a normal population. There were also significant differences between preoperative and postoperative ratings. The mean pre- and postoperative scores at night for those who reported complete improvement were 66.1 and 8.4, substantial improvement 74.5 and 24.2, and no improvement 83.3 and 76.4. The NSQ reliably assesses nasal symptoms in patients and may be useful for both short and long term prospective studies of septoplasty.

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Experience with Short and Long Term Courses of Local Adrenal Steroid Therapy For Ulcerative Colitis

Gastroenterology ◽

10.1016/s0016-5085(62)80117-6 ◽

1962 ◽

Vol 42 (6) ◽

pp. 669-677 ◽

Cited By ~ 18

Author(s):

Jean A. Spencer ◽

Joseph B. Kirsner

Keyword(s):

Ulcerative Colitis ◽

Steroid Therapy ◽

Adrenal Steroid ◽

Short And Long Term

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Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽

10.1024/1023-9332.7.1.20 ◽

2001 ◽

Vol 7 (1) ◽

pp. 20-24 ◽

Cited By ~ 14

Author(s):

Robert ◽

Mariéthoz ◽

Pache ◽

Bertin ◽

Caulfield ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Long Term Results ◽

Graves Disease ◽

Laryngeal Nerve Palsy ◽

Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

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