The nasal cycle before and after nasal septoplasty.

Abstract

Septoplasty is one of the most frequently performed operations in patients with septal deviation of the nose. The aim of this surgical intervention is to reduce nasal obstruction and to achieve a physiological nasal breathing. The nasal cycle plays a crucial role in this. The aim of this study was to investigate nasal breathing and the nasal cycle after septoplasty over a long period of time and under everyday conditions. We examined 22 healthy subjects and 19 patients with nasal septal deviation. They participated in two sessions separated by an interval of three months. Shortly after the first session patients received nasal septoplasty. Testing included multiple questionnaires regarding nasal breathing and olfactory function, anterior rhinoscopy, rhinomanometry, acoustic rhinometry, and long-term rhinoflowmetry over 24h. Nasal septoplasty was associated with subjectively improved nasal breathing and nasal patency comparable to that in healthy subjects. The severity of nasal obstruction was reduced. Nasal airflow and the hydraulic diameter increased on the deviated side of the nose while the inspiratory resistance did not significantly change. In addition, the number of phases of the nasal cycle decreased on the nondeviated side. Hence, the surgery was associated with a more even distribution of phases on both sides of the nose. Nasal septoplasty leads to a subjectively satisfactory result in patients with pathological septal deviation of the nose. In particular, septoplasty appears to be accompanied by a more even distribution of the nasal cycle across the two nasal cavities.