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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(02): e226-e232
DOI: 10.1055/s-0041-1730993
Original Article

Comparison of the Efficacy of Septoplasty with Nonsurgical Management in Improving Nasal Obstruction in Patients with Deviated Nasal Septum – A Randomized Clinical Trial

Dharanya Gopalakrishnan Srinivasan 
1   Department of Otorhinolaryngology, Shri Venkateshwaraa Medical College and Hospital, Puducherry, India
,
Jyotirmay Hegde 
2   Department of Otorhinolaryngology, Columbia Asia Hospital, Whitefield, Bangalore, India
,
Karthikeyan Ramasamy 
3   Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Kalaiarasi Raja 
3   Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Sathish Rajaa 
4   Department of Preventive and Social Medicine, JIPMER, Puducherry, India
,
Sivaraman Ganesan 
3   Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Prabu Velayutham 
1   Department of Otorhinolaryngology, Shri Venkateshwaraa Medical College and Hospital, Puducherry, India
,
Arun Alexander 
3   Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Sunil Kumar Saxena 
3   Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
› Author Affiliations Source of Funding None to declare.
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Abstract

Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven.

Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management.

Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups.

Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p = 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p = 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p = 0.001).

Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.

Keywords

visual analogue scale - PNIF - SNOT-22 - NOSE score - intranasal corticosteroids - topical decongestants

Note

The present paper was presented at the 14th Asia Oceana ORL-HNS Congress and AOICON 2019, held at Hyderabad, India, from 9 to 13 January 2019.




Publication History

Received: 02 January 2021

Accepted: 05 March 2021

Article published online:
23 August 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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