Download PDF
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(02): e266-e273
DOI: 10.1055/s-0042-1743462
Original Research

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study

María A. García-Chabur 
1   Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
4   Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
,
Juliana Castellanos 
1   Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
,
Gloria Corredor-Rojas 
2   School of Medicine, Universidad de Los Andes, Bogotá, Colombia
,
Mariana Salgar 
1   Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
,
Sergio Moreno 
2   School of Medicine, Universidad de Los Andes, Bogotá, Colombia
4   Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
,
Martín Pinzón 
1   Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
3   Department of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
4   Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
,
Augusto Peñaranda 
2   School of Medicine, Universidad de Los Andes, Bogotá, Colombia
3   Department of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
4   Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
› Author Affiliations Funding The present research did not receive any specific grant from funding agencies.
› Further Information
   Permissions and Reprints

Abstract

Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures.

Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes.

Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables.

Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53–- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores.

Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Keywords

nasal obstruction - nasal septum - nasal surgical procedures - quality of life - visual analogue scale

Ethics approval and consent to participate

Ethical Committee approval (CCEI-8616–2017).


Availability of data and materials

Part of the data generated or analyzed during the present study is included in the present published article. Full datasets generated during and/or analyzed during the present study are available from the corresponding author on reasonable request.


Contributions of the authors

García-Chabur MA, the first author of the study, contributed to the data collection, database construction, and manuscript writing.


Castellanos J., Salgar M., and Corredor-Rojas G. performed part of the data collection and contributed to the English translation of the article.


Moreno S. performed the statistical analysis and supported and guided the statistical data interpretation.


Pinzón M. and Peñaranda A. provided support on part of the data collection. García-Chabur MA, Corredor-Rojas G, and Peñaranda A. were involved in the drafting of the manuscript. Peñaranda A revised the manuscript critically for intellectual content. All authors read and approved the final manuscript for publication.


Supplementary Material



Publication History

Received: 09 September 2020

Accepted: 16 November 2021

Article published online:
14 February 2023

© 2023. 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/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Most SP, Rudy SF. Septoplasty: Basic and Advanced Techniques. Facial Plast Surg Clin North Am 2017; 25 (02) 161-169
    CrossrefPubMedGoogle Scholar
  • 2 Hsu DW, Suh JD. Anatomy and Physiology of Nasal Obstruction. Otolaryngol Clin North Am 2018; 51 (05) 853-865
    CrossrefPubMedGoogle Scholar
  • 3 Fraser L, Kelly G. An evidence-based approach to the management of the adult with nasal obstruction. Clin Otolaryngol 2009; 34 (02) 151-155
    CrossrefPubMedGoogle Scholar
  • 4 Li HY, Lee LA, Wang PC, Chen NH, Lin Y, Fang TJ. Nasal surgery for snoring in patients with obstructive sleep apnea. Laryngoscope 2008; 118 (02) 354-359
    CrossrefPubMedGoogle Scholar
  • 5 Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G. Long term results following nasal septal surgery. Focus on patients' satisfaction. Auris Nasus Larynx 2005; 32 (04) 369-374
    CrossrefPubMedGoogle Scholar
  • 6 Alakärppä AI, Koskenkorva TJ, Koivunen PT, Alho OP. Predictive factors of a beneficial quality of life outcome in patients undergoing primary sinonasal surgery: a population-based prospective cohort study. Eur Arch Otorhinolaryngol 2018; 275 (05) 1139-1147
    CrossrefPubMedGoogle Scholar
  • 7 Hsu HC, Tan CD, Chang CW. et al. Evaluation of nasal patency by visual analogue scale/nasal obstruction symptom evaluation questionnaires and anterior active rhinomanometry after septoplasty: a retrospective one-year follow-up cohort study. Clin Otolaryngol 2017; 42 (01) 53-59
    CrossrefPubMedGoogle Scholar
  • 8 Yepes-Nuñez JJ, Bartra J, Muñoz-Cano R. et al. Assessment of nasal obstruction: correlation between subjective and objective techniques. Allergol Immunopathol (Madr) 2013; 41 (06) 397-401
    CrossrefPubMedGoogle Scholar
  • 9 André RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ. Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol 2009; 34 (06) 518-525
    CrossrefPubMedGoogle Scholar
  • 10 Mozzanica F, Gera R, Bulgheroni C, Ambrogi F, Schindler A, Ottaviani F. Correlation between Objective and Subjective Assessment of Nasal Patency. Iran J Otorhinolaryngol 2016; 28 (88) 313-319
    PubMedGoogle Scholar
  • 11 Aziz T, Biron VL, Ansari K, Flores-Mir C. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg 2014; 43 (01) 11
    CrossrefPubMedGoogle Scholar
  • 12 Ottaviano G, Fokkens WJ. Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy 2016; 71 (02) 162-174
    CrossrefPubMedGoogle Scholar
  • 13 Cantone E, Ricciardiello F, Oliva F, De Corso E, Iengo M. Septoplasty: is it possible to identify potential “predictors” of surgical success?. Acta Otorhinolaryngol Ital 2018; 38 (06) 528-535
    CrossrefPubMedGoogle Scholar
  • 14 del Cuvillo A, Montoro J, Bartra J. et al. Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients - The ADRIAL cohort study. Rhinology 2010; 48 (02) 201-205
    PubMedGoogle Scholar
  • 15 Larrosa F, Roura J, Dura MJ, Guirao M, Alberti A, Alobid I. Adaptation and validation of the Spanish version of the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Rhinology 2015; 53 (02) 176-180
    CrossrefPubMedGoogle Scholar
  • 16 Keeler J, Most SP. Measuring Nasal Obstruction. Facial Plast Surg Clin North Am 2016; 24 (03) 315-322
    CrossrefPubMedGoogle Scholar
  • 17 Sanchez-Cuadrado I, Lassaletta L, Perez-Mora R, Muñoz E, Gavilan J. Reliability and validity of the Spanish Glasgow Benefit Inventory after cochlear implant surgery in adults. Eur Arch Otorhinolaryngol 2015; 272 (02) 333-336
    CrossrefPubMedGoogle Scholar
  • 18 Stewart MG, Smith TL, Weaver EM. et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004; 130 (03) 283-290
    CrossrefPubMedGoogle Scholar
  • 19 Valsamidis K, Titelis K, Karkos P, Markou K, Constantinidis J, Triaridis S. Predictive factors of patients' general quality of life after nasal septoplasty. Eur Arch Otorhinolaryngol 2019; 276 (02) 429-438
    CrossrefPubMedGoogle Scholar
  • 20 Pedersen L, Schiöler L, Finjan S. et al. Prognostic factors for outcome after septoplasty in 888 patients from the Swedish National Septoplasty Register. Eur Arch Otorhinolaryngol 2019; 276 (08) 2223-2228
    CrossrefPubMedGoogle Scholar
  • 21 Dinesh Kumar R, Rajashekar M. Comparative Study of Improvement of Nasal Symptoms Following Septoplasty with Partial Inferior Turbinectomy Versus Septoplasty Alone in Adults by NOSE Scale: A Prospective Study. Indian J Otolaryngol Head Neck Surg 2016; 68 (03) 275-284
    CrossrefPubMedGoogle Scholar
  • 22 Corredor-Rojas G, García-Chabur MA, Castellanos J, Moreno S, Pinzón M, Peñaranda A. Nasal Obstruction and Quality of Life Assessment After Septoplasty With Turbinoplasty: Correlation Between Subjective Scales. Am J Rhinol Allergy 2021; Sep; 35 (05) 568-573 DOI: 10.1177/1945892420978956.
    CrossrefPubMedGoogle Scholar
  • 23 Uppal S, Mistry H, Nadig S, Back G, Coatesworth A. Evaluation of patient benefit from nasal septal surgery for nasal obstruction. Auris Nasus Larynx 2005; 32 (02) 129-137
    CrossrefPubMedGoogle Scholar
  • 24 Lara-Sánchez H, Álvarez Nuño C, Gil-Carcedo Sañudo E, Mayo Iscar A, Vallejo Valdezate LÁ. Assessment of nasal obstruction with rhinomanometry and subjective scales and outcomes of surgical and medical treatment. Acta Otorrinolaringol Esp (Engl Ed) 2017; 68 (03) 145-150
    Google Scholar
  • 25 Karatzanis AD, Fragiadakis G, Moshandrea J, Zenk J, Iro H, Velegrakis GA. Septoplasty outcome in patients with and without allergic rhinitis. Rhinology 2009; 47 (04) 444-449
    PubMedGoogle Scholar
  • 26 Balistreri CR, Caruso C, Candore G. The role of adipose tissue and adipokines in obesity-related inflammatory diseases. Mediators Inflamm 2010; 2010: 802078
    CrossrefPubMedGoogle Scholar
  • 27 Allison DB, Downey M, Atkinson RL. et al. Obesity as a disease: a white paper on evidence and arguments commissioned by the Council of the Obesity Society. Obesity (Silver Spring) 2008; 16 (06) 1161-1177
    CrossrefPubMedGoogle Scholar
  • 28 Steele TO, Mace JC, DeConde AS. et al. Does comorbid obesity impact quality of life outcomes in patients undergoing endoscopic sinus surgery?. Int Forum Allergy Rhinol 2015; 5 (12) 1085-1094
    CrossrefPubMedGoogle Scholar