Nasal Eosinophilia in Septal and Turbinate Surgery Outcomes

Abstract

Objective 1) Determine the clinical outcome of septal and turbinate surgery. 2)Evaluate the potential predictive value of the nasal mucosal eosinophilia in this outcome. Methods A retrospective review of all patients who had undergone septoplasty with inferior turbinate reduction for symptomatic nasal obstruction was conducted in our department between September 2004 and September 2005. The Nasal Obstruction and Septoplasty Effectiveness (NOSE) score was used to assess the preoperative status and the postoperative outcome at one year. Nasal congestion, nasal blockage, trouble breathing through the nose, trouble sleeping, and inability to get enough air through the nose during exertion were evaluated. A histological study was undertaken on paraffin embedded surgical specimens, and a mean chorionic eosinophil count per microscopic field (40x) was performed. Patients were classified into 4 categories according to their mean eosinophilic count (<1cell, 1–3cells, 3–5cells, >5cells). Results 54 patients were included in the study (35 males and 19 females). The mean age was 31 years. A significant reduction of the NOSE score was noted a year after the intervention (22 vs. 61.7, p<0.0001), with a mean improvement rate of 67.5%. Better outcomes were observed in patients who had lower preoperative NOSE scores (p<0.0001), and lower eosinophil counts (p<0.0001). Conclusions Both preoperative NOSE score and histological eosinophilia seem to be major predictive factors of septal and turbinate surgery outcomes.