Abstract
The objective was to assess outcomes of nasal septoplasty without turbinectomy using validated subjective instruments and to correlate results with patient satisfaction. The prospective observational study was conducted in a tertiary referral center. The method included the use of NOSE and RhinoQoL questionnaires to assess patients before and 6 months after Cottle septoplasty without turbinectomy. Patient satisfaction was measured on a visual analog scale. Data were compared by the non-parametric Wilcoxon test. Minimal Clinically Important Differences (MCIDs) were calculated. Correlations between post-operative scores and patient satisfaction were assessed using the Spearman test. Univariate analysis was performed to assess predictors of improvement. One hundred patients were enrolled. Their mean age was 43.4 years and 28% had allergic rhinitis. There was a highly significant improvement in each score at 6 months (p < 0.00001). The MCID for the NOSE was comprised between 5 and 7.5, whereas the mean change was 35.2 points. They ranged from 3.8 to 6.1 for RhinoQoL scores, whereas mean changes were comprised between 12.6 and 20.9. Allergic rhinitis was a predictive factor of less improvement (NOSE p = 0.04–RhinoQoL p = 0.0001). Mean patient satisfaction was 8.2 ± 1.8. Post-operative NOSE and RhinoQoL frequency scores were moderately correlated (r = 0.380; r = 0.356, respectively) whereas bothersomeness and impact scores were highly correlated with patient satisfaction (r = 0.459; r = 0.443, p < 0.00001, respectively). This study shows that the NOSE and RhinoQoL questionnaires can be used in English- and French-speaking populations to perform pre- and post-therapeutic assessment. These validated instruments show that septoplasty without turbinectomy allows management of nasal obstruction and its burden.
Similar content being viewed by others
References
Jessen M, Ivarsson A, Malm L (1989) Nasal airway resistance and symptoms after functional septoplasty: comparison of findings at 9 months and 9 years. Clin Otolaryngol Allied Sci 14(3):231–234
Peacock MR (1981) Sub-mucous resection of the nasal septum. J Laryngol Otol 95(4):341–356
Samad I, Stevens HE, Maloney A (1992) The efficacy of nasal septal surgery. J Otolaryngol 21:88–91
Siegel N, Gliklich RE, Taghizadeh F, Chang Y (2000) Outcomes of septoplasty. Otolaryngol Head Neck Surg 122(2):228–232
Dinis PB, Haider H (2002) Septoplasty: long-term evaluation of results. Am J Otolaryngol 23:85–90
Stewart MG, Simth TL, Weaver EM et al (2004) Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 130(3):283–290
Harrill WC, Pillsbury HC, McGuirt WF, Stewart MG (2007) Radiofrequency turbinate reduction: a NOSE evaluation. Laryngoscope 117:1912–1919
Uppal S, Mistry H, Nadig S, Back G, Coatesworth A (2005) Evaluation of patient benefit from nasal septal surgery for nasal obstruction. Auris Nasus Larynx 32:129–137
André RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ (2009) Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol 34:518–525
Truilhe Y, Stoll D (2000) Nasal comfort and Cottle septoplasty. Prospective acoustic rhinometry study apropos of 102 cases. Rev Laryngol Otol Rhinol (Bord) 121(4):219–225
Carney AS, Bateman ND, Jones NS (2000) Reliable and reproducible anterior active rhinomanometry for the assessment of unilateral nasal resistance. Clin Otolaryngol Allied Sci 25(6):499–503
Blomgren K, Simola M, Hytönen M, Pitkäranta A (2003) Peak nasal inspiratory and expiratory flow measurements—practical tools in primary care? Rhinology 41(4):206–210
Boyce JM, Eccles R (2006) Assessment of subjective scales for selection of patients for nasal septal surgery. Clin Otolaryngol 31(4):297–302
Singh A, Patel N, Kenyon G, Donaldson G (2006) Is there objective evidence that septal surgery improves nasal airflow? J Laryngol Otol 120(11):916–920
Arunachalam PS, Kitcher E, Gray J, Wilson JA (2001) Nasal septal surgery: evaluation of symptomatic and general health outcomes. Clin Otolaryngol Allied Sci 26:367–370
Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157–163
Atlas SJ, Gallagher PM, Wu YA et al (2005) Development and validation of a new health-related quality of life instrument for patients with sinusitis. Qual Life Res 14(5):1375–1386
Atlas SJ, Metson RB, Singer DE, Wu YA, Gliklich RE (2005) Validity of a new health-related quality of life instrument for patients with chronic sinusitis. Laryngoscope 115(5):846–854
Marro M, Mondina M, Stoll D, de Gabory L (2011) French Validation of the NOSE and RhinoQoL questionnaires in the management of nasal obstruction. Otolaryngol Head Neck Surg 144(6):988–993
Brozek JL, Bousquet J, Baena-Cagnani CE et al (2010) Allergic Rhinitis and its impact of asthma (ARIA) guidelines:2010 Revision. J Allergy Clin Immunol 126(3):466–476
Guyatt GH, Osoba D, Wu AW, Wyrwich KW, Norman GR, The Clinical Significance Consensus Meeting Group (2002) Methods to explain the clinical significance of health status measures. Mayo Clin Proc 77(4):371–383
Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G (2005) Long term results following nasal septal surgery focus on patient’s satisfaction. Auris Nasus Larynx 32:369–374
Schwentner I, Dejakum K, Schmutzhard J, Deibl M, Sprinzl G (2006) Does nasal septal surgery improve quality of life? Acta Otolaryngol 126(7):752–757
Grymer LF, Illum P, Hilberg O (1993) Septoplasty and compensatory inferior turbinate hypertrophy: a randomized study evaluated by acoustic rhinometry. J Laryngol Otol 107(5):413–417
Illum P (1997) Septoplasty and compensatory inferior turbinate hypertrophy: long-term results after randomized turbinoplasty. Eur Arch Otorhinolaryngol 254(Suppl1):S89–S92
Lindemann J, Tsakiropoulou E, Konstantinidis I, Lindemann K (2010) Normal aging does not deteriorate nose-related quality of life: Assessment with “NOSE” and “SNOT-20” questionnaires. Auris Nasus Larynx 37(3):303–307
Karatzanis AD, Fragiadakis G, Moshandrea J, Zenk J, Iro H, Velegrakis GA (2009) Septoplasty outcome in patients with and without allergic rhinitis. Rhinology 47(4):444–449
Bousquet J, Neukirch F, Bousquet PJ et al (2006) Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol 117(1):158–162
Berger G, Hammel I, Berger R, Avraham S, Ophir D (2000) Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 110:2100–2105
Doorly DJ, Taylor DJ, Gambaruto AM, Schroter RC, Toiley N (2008) Nasal architecture: form and flow. Philos Trans R Soc A 366:3225–3246
Acknowledgments
The authors would like to thank Dr Ray Cooke for linguistic assistance.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mondina, M., Marro, M., Maurice, S. et al. Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol 269, 2189–2195 (2012). https://doi.org/10.1007/s00405-011-1916-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-011-1916-0