Evaluating the Effect of Spreader Grafting on Nasal Obstruction Using the NOSE Scale

2017 ◽  
Vol 126 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Aurora G. Standlee ◽  
Marc H. Hohman
Keyword(s):  
Nasal Obstruction ◽  
Surgical Techniques ◽  
Spreader Graft ◽  
Graft Placement ◽  
Nose Scale ◽  
Paired Samples ◽  
Symptom Evaluation ◽  
The Mean ◽  
The Difference ◽  
Mean Differences

Objective: The Nasal Obstruction Symptom Evaluation (NOSE) scale has been used to demonstrate that surgery improves nasal obstruction, but no study has directly compared surgical techniques. We performed a retrospective study comparing NOSE scores to quantify the effects of spreader grafting on postoperative nasal patency. Methods: We compared NOSE scores of patients who underwent septoturbinoplasty to open septorhinoplasty with spreader graft placement. We used a paired samples t test to evaluate the difference between pre- and postoperative NOSE scores and the improvement in NOSE score between patients who underwent septoturbinoplasty and those who underwent open septorhinoplasty with spreader graft placement. Results: Surgery reduced NOSE scores by an average of 46 points ( P < .001). The mean differences in NOSE score across all time points after septoturbinoplasty and septorhinoplasty with spreader graft placement was 40 and 49, respectively. The mean improvement in NOSE score at the second follow-up appointment was 27 for patients who had undergone septoturbinoplasty and 51 for patients who had undergone septorhinoplasty with spreader graft placement ( P = .04). Conclusion: This is the largest study quantifying the effect of spreader grafting. Greater improvement was observed from septorhinoplasty with spreader graft placement than septoturbinoplasty, and this improvement persisted over time.

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

scholarly journals Assessment of Septoplasty Outcome using Nasal Obstruction Symptom Evaluation Scale

2019 ◽  
Vol 21 (2) ◽  
pp. 142-146
Author(s):  
Kundan Kumar Shrestha ◽  
R.R. Joshi ◽  
A.S. Rijal ◽  
A. Dhungana ◽  
S. Maharjan
Keyword(s):  
Quality Of Life ◽  
Nasal Obstruction ◽  
Septal Deviation ◽  
Definitive Treatment ◽  
Nose Scale ◽  
Outcome Instrument ◽  
Symptom Evaluation ◽  
The Mean ◽  
Nasal Septoplasty

 Nasal obstruction, the most common presenting symptom in nasal and sinus disease, is defined as patient discomfort manifested as a sensation of insufficient airflow through the nose. Nasal septal deviation is the most common anatomical cause of nasal obstruction. Surgical correction of a deviated septum, nasal septoplasty, is the definitive treatment for septal deviation. Many studies have discussed about outcomes of septoplasty. However, there is limited published literature on nasal septoplasty and its outcome in Nepal. The aim of this study is to evaluate the outcome of septoplasty using Nasal Obstruction Symptom Evaluation (NOSE) scale, a validated outcome instrument assessing quality of life (QoL) related to nasal obstruction. A total of 52 patients aged 18 years and above, with nasal obstruction at least for 3 months, undergoing septoplasty alone were included in the study. Baseline NOSE score was calculated a week before surgery. The patients were followed up after 3 months to record postoperative NOSE score. On statistical analysis, the mean NOSE scores before and 3 months after septoplasty were 45.58±21.38 and 8.46±8.37 respectively. The mean difference was 37.11± 21.22 and p value on paired t test was less than 0.001(highly significant). The mean differences of each component of the NOSE scale questionnaire were also found to be highly significant statistically with p values less than 0.001. Gender and age did not seem to affect the outcomes. In conclusion, NOSE scale is a valid, reliable and responsive instrument that is brief and easy to complete and has potential use for outcome studies in adults with nasal obstruction. This instrument showed that septoplasty, if done in properly selected patients, results in significant improvement in nasal obstruction and disease specific quality of life with high patient satisfaction.

scholarly journals Respiratory mode, nasal patency and palatine dimensions

CoDAS ◽  
2015 ◽  
Vol 27 (2) ◽  
pp. 201-206 ◽  
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.

Nasale Obstruktion wie operativ behandeln?

2017 ◽  
Vol 96 (06) ◽  
pp. 348-350
Keyword(s):  
Nasal Obstruction ◽  
Nose Scale ◽  
Symptom Evaluation ◽  
Nasale Obstruktion

Standlee AG et al. Evaluating the Effect of Spreader Grafting on Nasal Obstruction Using the NOSE Scale. Ann Otol Rhinol Laryngol. 2017; 126: 219–223 Die Nasenobstruktion ist das am häufigsten auftretende Symptom bei Erkrankungen von Nase und Nebenhöhlen. Der Therapieerfolg eines operativen Eingriffs lässt sich anhand der Nasal Obstruction Symptom Evaluation (NOSE)-Scale beurteilen. Amerikanische Ärzte bewerteten nun die NOSE-Scores, um Wirksamkeit von Dehnungsimplantaten auf die postoperative nasale Funktion zu bestimmen.

scholarly journals The reproducibility of subjective appetite scores

1995 ◽  
Vol 73 (4) ◽  
pp. 517-530 ◽  
Author(s):  
Anne Raben ◽  
ANNA TAGLIABUE ◽  
Arne Astrup
Keyword(s):  
Visual Analogue Scale ◽  
Food Consumption ◽  
Analogue Scale ◽  
Prior Experience ◽  
Random Noise ◽  
Normal Weight ◽  
Vas Scores ◽  
The Mean ◽  
The Difference ◽  
Mean Differences

Although subjective appetite scores are widely used, studies on the reproducibility of this method are scarce. In the present study nine healthy, normal weight, young men recorded their subjective appetite sensations before and during 5 h after two different test meals A and B. The subjects tested each meal twice and in randomized order. Visual analogue scale (VAS) scores, 10 cm in length, were used to assess hunger, satiety, fullness, prospective food consumption and palatability of the meals. Plasma glucose and lactate concentrations were determined concomitantly. The repeatability was investigated for fasting values, Δ-mean 5 h and mean 5 h values, Δ-peak/nadir and peak/nadir values. Although the profiles of the postprandial responses were similar, the coefficients of repeatability (CR = 2SD) on the mean differences were large, ranging from 2·86 to 5.24 cm for fasting scores, 1·36 to 1·88 cm for mean scores, 2·98 to 5·42 cm for Δ-mean scores, and 3·16 to 6·44 cm for peak and Δ-peak scores. For palatability ratings the CK values varied more, ranging from 2·38 (taste) to 8·70 cm (aftertaste). Part of the difference in satiety ratings could be explained by the differences in palatability ratings. However, the low reproducibility may also be caused by a conditioned satiation or hunger due to the subjects' prior experience of the meals and therefore not just be a reflection of random noise. It is likely, however, that the variation in appetite ratings is due both to methodological day-to-day variation and to biological day-to-day variation in subjective appetite sensations.

scholarly journals Nasal airway function after Le Fort I osteotomy with maxillary impaction: A prospective study using the Nasal Obstruction Symptom Evaluation scale

2021 ◽  
Vol 48 (1) ◽  
pp. 61-68
Author(s):  
Hyo Seong Kim ◽  
Ji Hwan Son ◽  
Jee Hyeok Chung ◽  
Kyung Sik Kim ◽  
Joon Choi ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Patient Characteristics ◽  
Rank Test ◽  
Nasal Airway ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Nose Scale ◽  
Airway Function ◽  
Symptom Evaluation ◽  
Le Fort I

Background This study evaluated changes in nasal airway function following Le Fort I osteotomy with maxillary impaction according to the Nasal Obstruction Symptom Evaluation (NOSE) scale.Methods This cohort study included 13 patients who underwent Le Fort I osteotomy with maxillary impaction. Nasal airway function was evaluated based on the NOSE scale preoperatively and at 3 months postoperatively. The change in the NOSE score was calculated as the preoperative score minus the postoperative score. If the normality assumptions for changes in the NOSE score were not met, a nonparametric test (the Wilcoxon signed-rank test) was used. Differences in NOSE score changes according to patient characteristics and surgical factors were evaluated using the Kruskal-Wallis test and the Mann-Whitney test.Results Patients ranged in age from 18 to 29 years (mean±standard deviation [SD], 23.00±3.87 years). Three were men and 10 were women. Eleven patients (84%) had an acquired dentofacial deformity with skeletal class III malocclusion. The preoperative NOSE scores ranged from 40 to 90 (mean±SD, 68.92±16.68), and the postoperative NOSE scores ranged from 25 to 80 (53.84±18.83). The cohort as a whole showed significant improvement in nasal airway function following maxillary impaction (P=0.028). Eleven patients (84%) had either improved (n=8) or unchanged (n=3) postoperative NOSE scores. However, nasal airway function deteriorated in two patients. Patient characteristics and surgical factors were not correlated with preoperative or postoperative NOSE scores.Conclusions Nasal airway function as evaluated using the NOSE scale improved after maxillary impaction.

scholarly journals Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea

2020 ◽  
Vol 8 (4) ◽  
pp. 119
Author(s):  
Arisa Sawa ◽  
Hiroshi Suzuki ◽  
Hideo Niwa ◽  
Sumito Oguchi ◽  
Tatsuo Yagi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Standard Technique ◽  
Apnea Hypopnea Index ◽  
Nasal Airflow ◽  
Nose Scale ◽  
Symptom Evaluation ◽  
Obstructive Sleep ◽  
Scale Scores

Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of a portable lightweight peak nasal inspiratory flow (PNIF) rate meter to objectively assess nasal airflow and utilized the Nasal Obstruction Symptom Evaluation (NOSE) scale to subjectively assess nasal obstruction in 97 patients with OSA and 105 healthy controls. We examined the correlations between the following variables between the groups: demographics, body mass index, PNIF, NOSE scale scores, apnea–hypopnea index (AHI), minimum SpO2 (SpO2min), Mallampati classification, and Epworth Sleepiness Scale (ESS) scores. Patients with OSA had significantly lower PNIF values and higher NOSE scores than controls. In the patient group, PNIF was not significantly correlated with AHI, SpO2min, Mallampati classification, or NOSE or ESS scores. Lower PNIF values and higher NOSE scores suggested impaired nasal airflow in the OSA group. As daytime PNIF measurement bears no relationship to AHI, this cannot be used alone in predicting the suitability of treatment for OSA with OA but can be used as an adjunct for making clinical decisions.

scholarly journals Clinical Evaluation of a Polish Translation and Cross-Cultural Adaptation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale

2018 ◽  
Vol 24 ◽  
pp. 7958-7964 ◽  
Author(s):  
Justyna Dąbrowska-Bień ◽  
Henryk Skarżyński ◽  
Elżbieta Gos ◽  
Iwonna Gwizdalska ◽  
Katarzyna Bożena Lazecka ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Clinical Evaluation ◽  
Cultural Adaptation ◽  
Cross Cultural ◽  
Cross Cultural Adaptation ◽  
Nose Scale ◽  
Symptom Evaluation

Systematic Review and Meta-analysis of Studies Evaluating Functional Rhinoplasty Outcomes with the NOSE Score

2017 ◽  
Vol 156 (5) ◽  
pp. 809-815 ◽  
Author(s):  
Elizabeth Mia Floyd ◽  
Sandra Ho ◽  
Prayag Patel ◽  
Richard M. Rosenfeld ◽  
Eli Gordin
Keyword(s):  
Nasal Obstruction ◽  
Observational Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Mean Difference ◽  
Large Variability ◽  
Symptom Evaluation ◽  
Study Results ◽  
Independent Screening ◽  
The Mean

Objective To provide aggregate data regarding the ability of functional rhinoplasty to improve nasal obstruction as measured by the Nasal Obstruction Symptom Evaluation (NOSE) score. Data Sources PubMed, EMBASE, Cochrane databases. Review Methods A search was performed with the terms “nasal obstruction” and “rhinoplasty.” Studies were included if they evaluated the effect of functional rhinoplasty on nasal obstruction with the NOSE score. Case reports, narratives, and articles that did not use the NOSE score were excluded. Functional rhinoplasty was defined as surgery on the nasal valve. This search resulted in 665 articles. After dual-investigator independent screening, 16 articles remained. Study results were pooled with a random effects model of meta-analysis. Change in NOSE score after surgery was assessed via the mean difference between baseline and postoperative results and the standardized mean difference. Heterogeneity was assessed and reported through the I2 statistic. Results Patients in the included studies had moderate to severe nasal obstructive symptoms at baseline. The NOSE scores were substantially improved at 3-6, 6-12, and ≥12 months, with absolute reductions of 50 points (95% CI, 45-54), 43 points (95% CI, 36-51), and 49 points (95% CI, 39-58), respectively. All of these analyses showed high heterogeneity. Conclusions Nasal obstruction as measured by the NOSE survey is reduced by 43 to 50 points (out of 100 points) for 12 months after rhinoplasty. Our confidence in these results is limited by heterogeneity among studies, large variability in outcomes beyond 12 months, and the inherent potential for bias in observational studies.

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