Abstract
Ever since the introduction of the concept of Procedures of Limited Clinical Value
(PoLCV), procedures such as functional septorhinoplasty have been subject to additional
funding restrictions within the British National Health Service. Recent publications
have suggested that 10% of Clinical Commissioning Groups in the United Kingdom no
longer fund septorhinoplasty surgery irrespective of the indications, including congenital
malformations or post-trauma, and despite the strong evidence available in the literature
in treating a range of health conditions. Thus, inequity exists across the country.
At present functional septorhinoplasty surgery is frequently but incorrectly grouped
together with aesthetic rhinoplasty, both of which are deemed to be cosmetic interventions.
Moreover, as we exit the peak of the current coronavirus disease 2019 (COVID-19) pandemic,
procedures deemed to be of lower clinical priority will potentially be at risk throughout
Europe. The purpose of this review is twofold; the first is to put forward the evidence
to commissioners in favor of functional septorhinoplasty surgery on patient well-being
and mental health; the second is to demonstrate why functional septorhinoplasty surgery
is a distinct procedure from aesthetic rhinoplasty and why it ought not to be classified
as a procedure of limited clinical value.
Keywords
evidence-based medicine - nasal obstruction - nasal septum - rhinoplasty - sleep apnea
- obstructive
