Comparison of the Efficacy of Septoplasty with NonSurgical Management in Improving Nasal Obstruction in Patients with Deviated Nasal Septum - A Randomized Clinical Trial

Abstract Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven. Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management. Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups. Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p = 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p = 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p = 0.001). Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.

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Evaluation of the quality of life before and after septoplasty among patients with deviated nasal septum using nasal obstruction symptom evaluation questionnaire

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203574 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1689

Author(s):

Farah Deeba ◽

Faheem Khalid ◽

Rauf Ahmed

Keyword(s):

Quality Of Life ◽

Nasal Obstruction ◽

Nasal Septum ◽

Deviated Nasal Septum ◽

Medical College ◽

Symptom Evaluation ◽

Before And After ◽

Related Quality ◽

Health Related

Background: The objective of the study was to evaluate the quality of life before and after septoplasty among patients with nasal obstruction.Methods: This study was done in Government Medical College Srinagar from September 2017 to September 2018 for a period of 12 months. A total of 33 patients with deviated nasal septum who underwent septoplasty were included in the study. They were given a questionnaire nasal obstruction symptom evaluation (NOSE) to be fulfilled preoperatively, then 3 months and at 6 months after surgery.Results: The preoperative NOSE score was 72.62±22.69 and postoperative score was 10.78±15.27 at 3 months, 5.72±10.1 at 6 months.Conclusions: Disease specific health related quality of life measured with NOSE in patients undergoing septoplasty showed improvement at 3 months and 6 months postoperatively.

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Comparing the outcome of septoplasty and septoplasty with turbinectomy in patients with deviated nasal septum

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193616 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1185

Author(s):

Nayanna Karodpati ◽

Mayur Ingale ◽

Sharad Rawat ◽

Vinayak Kuradagi

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Inferior Turbinate ◽

Symptom Improvement ◽

Deviated Nasal Septum ◽

Medical College ◽

Turbinate Hypertrophy ◽

Symptom Evaluation ◽

Postoperative Symptoms ◽

Inferior Turbinate Hypertrophy

Background: Deviated nasal septum is a bodily disorder results in nasal obstruction. Many surgical procedures are available in correcting the disorder. The present study aimed to compare the surgical outcome of septoplasty alone and septoplasty with turbinectomy in patients with deviated nasal septum.Methods: This prospective study was done on 50 patients attending to the department of ENT of Dr. D. Y. Patil Medical College and Hospital, DPU with complaints of nasal obstruction due to inferior turbinate hypertrophy with deviated nasal septum. The severity of nasal obstruction was assessed by NOSE (nasal obstruction symptom evaluation) scale. Of them, 25 patients were managed with septoplasty alone and other 25 patients with septoplasty and turbinectomy. The outcome of both the procedures was assessed statistically by using NOSE scale. Results: Postoperative symptom improvement was seen in the both groups following surgery (p<0.05). When the NOSE scores are compared between two groups, statistically significant improvement in the symptoms (NOSE score) was seen in the group of patients treated with septoplasty and turbinectomy compared to septoplasty alone (p<0.05).Conclusions: This study re-iterates both septoplasty and concurrent turbinectomy are established mode of treatment in deviated nasal septum along with hypertrophy of inferior turbinates when the preoperative and postoperative symptoms are compared. However, the symptomatic outcomes and diagnostic nasal endoscopic findings are significantly better in patients who underwent septoplasty with concurrent resection of the inferior turbinate.

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Role of septoplasty in allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203570 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1667

Author(s):

Hiten R. Maniyar ◽

Dharmishtha H. Parmar

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Obstruction ◽

Nasal Septum ◽

Common Symptom ◽

Age Group ◽

Control Test ◽

Deviated Nasal Septum ◽

Nose Scale

Background: It is a prospective study of 30 cases of allergic rhinitis with deviated nasal septum presented to our hospital. Analysis is done on the basis of age and sex distribution, severity of the symptoms pre and post operatively, according to nasal obstruction symptom evaluation (NOSE) scale and allergic rhinitis control test (ARCT) questionnaire which assess the quality of life.Methods: Detailed history taking and clinical examination was done. All the patients were assessed the severity of their symptoms based on a NOSE scale. An ARCT questionnaire was given to patients prior to surgery(septoplasty) and after 3 months of it.Results: In study we have observed that in the age group was 20-30years. Majority of the patients were males. The most common symptom is nasal obstruction followed by sneezing, rhinorhhea, pruritis, headache etc. The mean decrease in the NOSE score was statistically significant (before septoplasty NOSE score =14.6 and after septoplasty NOSE score=8.1). There is also improvement in quality of life which was measured by allergic rhinitis control test (ARCT) score. ARCT before septoplasty 10.2 and after 19.2.Conclusion: The study shows most common combined symptoms are nasal blockage with rhinorrhoea, more affecting the age group of 18 to 30 years, males, with deviated nasal septum towards left seen more commonly. Patients of allergic rhinitis with deviated nasal septum are benefited with septoplasty, improved symptoms like nasal obstruction and stuffiness etc. and the quality of life by decrease in the severity of allergic symptoms.

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Is Computed Tomography Imaging of Deviated Nasal Septum Justified for Obstruction Confirmation?

Ear Nose & Throat Journal ◽

10.1177/0145561319871533 ◽

2019 ◽

pp. 014556131987153 ◽

Cited By ~ 1

Author(s):

Natasa Janovic ◽

Aleksa Janovic ◽

Biljana Milicic ◽

Marija Djuric

Keyword(s):

Computed Tomography ◽

Nasal Obstruction ◽

Nasal Septum ◽

Anterior Part ◽

Third Party ◽

Computed Tomography Imaging ◽

Deviated Nasal Septum ◽

Symptom Evaluation ◽

Measured Angle ◽

Obstruction Severity

Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified.

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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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Efficiency of modified Goldman’s technique in open pediatric septoplasty

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00074-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Omar Sabry ◽

Hazem Dewidar ◽

Mosaad abdel Aziz ◽

Amr Elemam ◽

Ahmed Nassar

Keyword(s):

Nasal Septum ◽

Pediatric Population ◽

Septal Deviation ◽

Nasal Resistance ◽

Deviated Nasal Septum ◽

Assessment Protocol ◽

Nose Scale ◽

Detailed Assessment

Abstract Background Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades. In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively. In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique. They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry. Results There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s. Conclusions Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.

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Quality of Life in Patients with Nasal Obstruction after Septoplasty: A Single Institution Prospective Observational Study

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1722162 ◽

2021 ◽

Author(s):

Justyna Dąbrowska-Bień ◽

Henryk Skarżyński ◽

Sebastian Filip Górski ◽

Piotr Henryk Skarżyński

Keyword(s):

Quality Of Life ◽

Observational Study ◽

Nasal Obstruction ◽

Prospective Observational Study ◽

Common Symptom ◽

Single Institution ◽

High Satisfaction ◽

Symptom Evaluation ◽

The Individual

Abstract Introduction Nasal obstruction is a common symptom in otorhinolaryngological practice. It can impact significantly on the quality of life of the individual. Objective The primary goal of the present study was to evaluate quality of life after septoplasty in adults with nasal obstruction. A secondary goal was to assess the effectiveness of septoplasty. Methods This was a single institution prospective observational study. Patients had experienced septal deviation and symptomatic nasal obstruction with no benefit from medical treatment. There were 51 patients who completed the Nasal Obstruction Symptom Evaluation (NOSE-POL) scale as well as theVisual Analogue Scale (VAS) before undergoing septoplasty, 3 months later, and finally 7 months after surgery. Patients evaluated changes in their nasal obstruction and changes in their quality of life using the Clinical Global Impression Scale (CGI-S). Results There was a significant improvement in nasal obstruction after septoplasty. Before septoplasty, the mean score on NOSE was 60.3 ± 20.4; 3 months after surgery, it was 32.9 ± 16.8; and 7 months after surgery it was 39.6 ± 33.2. The VAS results also proved a significant enhancement in nasal obstruction after septoplasty. Patients reported an improvement in nasal obstruction as well as a positive change in quality of life, confirming the effectiveness of septoplasty. Conclusions In patients with deformed septum, septoplasty contributes to high satisfaction of the patient and a compelling improvement in disease-specific quality of life. The NOSE-POL questionnaire is a useful tool for measuring the outcomes of this procedure.

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Respiratory mode, nasal patency and palatine dimensions

CoDAS ◽

10.1590/2317-1782/20152014177 ◽

2015 ◽

Vol 27 (2) ◽

pp. 201-206 ◽

Cited By ~ 7

Author(s):

Maria Elaine Trevisan ◽

José Humberto Bellinaso ◽

Andrielle de Bitencourt Pacheco ◽

Luciana Barros Augé ◽

Ana Maria Toniolo da Silva ◽

...

Keyword(s):

Nasal Obstruction ◽

Negative Correlation ◽

Hard Palate ◽

Nasal Patency ◽

Nasal Breathing ◽

Nose Scale ◽

Symptom Evaluation ◽

Plaster Models ◽

Digital Caliper ◽

Peak Nasal Inspiratory Flow

Purpose: To investigate the influence of breathing mode and nasal patency in the dimensions of the hard palate by comparing mouth breathing (MB) and nasal breathing (NB) adults. Methods: Seventy-seven individuals, distributed into the MB group (n=38) and the NB group (n=39), of both genders and aged between 18 and 30 years old, took part in the study. The respiratory mode diagnosis was based on anamnesis, physical characteristics, and otorhinolaryngological examination. The volunteers were evaluated in terms of nasal patency, with a peak nasal inspiratory flow (PNIF) meter, and obstruction symptoms, by a Nasal Obstruction Symptom Evaluation (NOSE) scale, and had their transversal and vertical hard palate dimensions measured with a digital caliper in plaster models. Results: Comparing both groups, the MB group presented significantly higher values in the NOSE scale, lower values in the PNIF, lower values in the transversal distance of the palate in the intercanine region, and significantly higher values in the vertical distance in the regions of the first and second premolars and molars. There was a negative correlation between PNIF and NOSE, and a positive correlation between PNIF and transversal distance of the palate in the region of the first premolars. Conclusion: MB adults presented reduced nasal patency and a higher degree of nasal obstruction symptoms. The hard palate was morphologically narrower and deeper in adults with the MB mode compared to the NB mode. Moreover, it was concluded that the smaller the nasal patency, the greater the obstruction symptoms and the narrower the hard palate.

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An endoscopic approach to the deviated nasal septum – a preliminary study

The Journal of Laryngology & Otology ◽

10.1017/s0022215100142124 ◽

1998 ◽

Vol 112 (10) ◽

pp. 934-939 ◽

Cited By ~ 20

Author(s):

Dipak Ranjan Nayak ◽

R. Balakrishnan ◽

K. Deepak Murthy

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Objective Assessment ◽

Subjective Assessment ◽

Endoscopic Approach ◽

Lateral Nasal Wall ◽

Combined Approach ◽

Deviated Nasal Septum ◽

Nasal Endoscope ◽

Preliminary Study

AbstractThe authors have used the nasal endoscope for the precise identification of pathological abnormalities of the nasal septum in relation to the lateral nasal wall including the osteo-meatal complex and in its ultraconservative management. The aim of the study was to compare the efficacies of endoscope-aided septoplasty (EAS) over traditional septoplasty (TS) in treating the pathological septum and turbinates, performed in 30 cases each. The subjective assessment was carried out by visual analogue scores and objective assessment by nasal endoscopy. This study demonstrates the superiority and limitations of the endoscopic approach in managing a deviated nasal septum and the turbinates. The endoscope-aided technique was found to be more effective in relieving the contact areas and nasal obstruction (p = ≤0.05). The authors advocate a combined approach – an endoscopic approach for inaccessible posterior deviation and the conservative traditional technique for accessible anterior deviation of the nasal septum.

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