Abstract
PurposeSeptal deviation and nose deformities are widely prevalent. As a consequence, patients may complain about difficulties in nasal breathing leading to a perception of diminished disease-specific quality of life. In a prospective randomized trial, we aimed to analyse the outcome of septoplasty (SPL) and septorhinoplasty (SRP) on patient satisfaction.MethodsPatients with functional indication for SPL (n = 19) or SRP (n = 54) were included and randomized for additional turbinoplasty. Preoperative clinical symptoms were collected with SNOT-20 GAV (Sinu-nasal outcome test-20—German adapted version) and NOSE© (nasal obstruction symptom evaluation) questionnaires. The final evaluation of treatment success was performed 9 months after surgery with SNOT-20 GAV, NOSE© and a self-established feedback questionnaire. Nasal breathing and obstruction were objectively measured with rhinomanometry and acoustic rhinometry [minimum cross-sectional area 2 (MCA2)].ResultsMinimum cross-sectional area 2 was statistically improved compared to the pre-treatment value in SPL (p = 0.0004) and SRP (p = 0.0001). Regarding MCA2 values of matched patient groups, similar findings were detected (SPL: p = 0.0013, SRP: p < 0.0001).Sinu-nasal outcome test-20 GAV and NOSE© scores were significantly reduced after both surgical procedures (NOSE©: SPL: p < 0.0001, SRP: p < 0.0001; SNOT-20 GAV: SPL: p = 0.0068, SRP: p < 0.0001). Evaluation of patient satisfaction in a self-established feedback questionnaire revealed a motivation of 81% of patients to redo the surgery (SPL 13/16, SRP 34/42) and a notably general satisfaction of 86% for SPL and 80% for SRP.ConclusionRhinosurgery leads to quantitative better nasal breathing and increased disease-specific satisfaction. However, this study implies the importance of the right selection of patients and the correct indication of the surgical technique.
Highlights
Septal deviation and deviated nose deformities are widely prevalent, with a rather high incidence [1]
Deviation of the inner and outer nose is not necessarily related to clinical symptoms. Some patients with these anatomical variations complain about difficult nasal breathing leading to a reduced quality of life (QOL)
Considering pre and postoperative minimum crosssectional area 2 (MCA2) for both surgical approaches, a significant increase could be shown after SPL (p = 0.0004) and SRP (p = 0.0003)
Summary
Septal deviation and deviated nose deformities are widely prevalent, with a rather high incidence [1]. Deviation of the inner and outer nose is not necessarily related to clinical symptoms. Some patients with these anatomical variations complain about difficult nasal breathing leading to a reduced quality of life (QOL). There are objective measurements available to assess nasal breathing, but their results are frequently not appropriate to the patient’s opinion [3,4,5]. The benefit to the QOL of rhinosurgical procedures like septoplasty (SPL) or septorhinoplasty (SRP) remains controversial [6]. SPL and SRP belong to the most frequent surgical procedures in otorhinolaryngology. In Germany, in 2018, more than 100.000 SPL and 13.000 SRP procedures were undertaken [7].
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