Abstract
The aim of this study was to explore the usefulness of unilateral, combined unilateral (left + right), and bilateral peak nasal inspiratory flow (PNIF) measurements in assessing the results of nasal septal surgery. Nasal obstruction was recorded subjectively and objectively before and 4 months after nasal septoplasty using a visual analogue scale (VAS) and a PNIF meter. Nasal septoplasty (58 patients) and septoplasty with turbinoplasty (68 patients) were performed on 126 patients (85 males; 41 females) with a mean age of 32.8 years. The results showed a significant improvement in VAS scores, as well as unilateral, combined unilateral, and bilateral PNIF values after both septoplasty and septoplasty with turbinoplasty. Septoplasty with turbinoplasty showed better improvement in VAS and PNIF scores than septoplasty alone and this was significant for bilateral PNIF scores. The best unilateral pre- and postoperative correlations between VAS and PNIF measurements were found using the lower of the two unilateral PNIF scores, irrespective of side. In the total material, VAS/PNIF correlations were mostly significant, but weak (all r<0.30). We found VAS and PNIF to be useful instruments in reporting results of surgery. The weak correlations between VAS and PNIF measurements suggest that these subjective and objective instruments may target different aspects of nasal obstruction.
Highlights
Nasal septal deviation is a common cause of nasal obstruction that can be treated surgically
To examine whether the observed correlations between the visual analogue scales (VAS) and peak nasal inspiratory flow (PNIF) parameters were influenced by the effects of age and nasal allergy, multiple regression analyses were performed. The results of these adjusted analyses indicated that while the direction of associations was the same, the strength of the VAS and PNIF associations was somewhat attenuated by controlling for these confounding factors. In this prospective study of the results of nasal septal surgery, we found statistically significant improvement in both subjective (VAS) and objective (PNIF) measurements following nasal surgery whether septoplasty alone or septoplasty with turbinoplasty was performed
Looking at the total surgical cohort, we found a significant correlation between the VAS scores and the unilateral and bilateral PNIF recordings both pre- and postoperatively, except for the preoperative measure on the left side
Summary
Nasal septal deviation is a common cause of nasal obstruction that can be treated surgically. The decision to operate is usually made by the surgeon on clinical grounds alone without using objective measurements. The results of surgery are not always satisfactory and preoperative objective measurements might improve the selection of patients for surgery. Rhinomanometry is regarded as the gold standard in objective measurements of nasal obstruction, but it is relatively expensive and time consuming and requires experience. Bilateral measurements have been used for many years to assess the results of nasal allergy treatment. Unilateral measurements, while not widely used clinically, have been included in some studies of nasal obstruction [2]. The use of PNIF measurements has not been approved for assessing the results of treatment of unilateral nasal obstruction [3]. Further studies of PNIF measurements for this purpose should be explored
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