Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals

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Abstract

Background

The goal of this study is to compare quality of life (Qol) and symptoms in 91 patients with a deviated nasal septum preoperatively and postoperatively with a control group of 93 healthy individuals.

Methods

All patients reported Qol on Sino-Nasal-Outcome-Test-20 (SNOT-20) and symptoms on visual analogue scale (VAS) preoperatively and 6 months after surgery and the results were compared with the controls.

Results

Mean SNOT-20 score improved from 1.8(SD0.9) preoperatively to 0.9(SD0.8) postoperatively ( p < 0.000) but did not reach the same level as the controls 0.4(SD0.5). Septum surgery leads to a significant symptom improvement for all symptoms investigated ( p < 0.000) on VAS. The patients reached the same level as the healthy controls in 6 of 11 symptoms (headache, facial pain, sneezing, trouble with rhinosinusitis, cough and snoring) but the patients group had significantly more trouble with nasal blockage (VAS 29 vs 9), change in sense of smell (VAS 12 vs5), nasal discharge (VAS 22 vs 11), oral breathing (VAS 23 vs 13) and reduced general health (VAS 12 vs 5) also postoperatively ( p < 0.01). Sub analyses showed that allergic patients reported a VAS score of 36 (SD30) for nasal blockage and 17 (SD22) for facial pressure postoperatively versus 23(SD22) and 6(SD13) in non-allergic patients ( p < 0.03 and p < 0.01). Patients with obstructive sleep apnea syndrome (OSAS) reported more trouble with snoring on VAS postoperatively than other patients, 42(SD28) versus 20(SD23) ( p < 0.002).

Conclusion

Septoplasty leads to a highly significant improvement in Qol and symptoms. The patients do not reach the same level of Qol as healthy controls. All symptoms are reported as mild on VAS postoperatively.

Allergic patients tend to report more nasal blockage and facial pressure postoperatively than other patients and a focus on medical treatment should be kept also postoperatively. Patients with obstructive sleep apnea report more trouble with snoring postoperatively and alterative treatment options for snoring may be considered in these patients.

Electronic supplementary material

The online version of this article (doi:10.1186/s12901-016-0031-7) contains supplementary material, which is available to authorized users.

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Most cited references 13

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EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

W.J. Fokkens, V.J. Lund, J Mullol … (2012)

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

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Prevalence and rate of diagnosis of allergic rhinitis in Europe.

V Bauchau, S. R. Durham (2004)

To measure the prevalence of allergic rhinitis among European adults and the proportion of undiagnosed subjects, a two-step, cross-sectional, population-based survey in Belgium, France, Germany, Italy, Spain, and the UK was undertaken. Step one of the study involved screening for allergic rhinitis by telephone interview, based on history of symptoms and/or self-awareness of the condition. Step two undertook confirmation of allergic rhinitis in a subset of the subjects screened positive; this was performed by a clinical diagnosis conducted in three to five clinical centres per country, including specific immunoglobulin E tests and a disease-specific questionnaire. A total of 9,646 telephone interviews were conducted between February and April 2001. Self-awareness of allergic rhinitis was reported by 19% of the subjects. Physician-based diagnosis of allergic rhinitis was reported by 13% of the subjects. In step two, 725 clinical assessments were conducted between May and August 2001. A total of 411 of patients, who underwent step two, had investigator-confirmed allergic rhinitis. Among patients with investigator-confirmed allergic rhinitis, 45% had not reported a previous diagnosis by a physician. Prevalence of subjects with clinically confirmable allergic rhinitis estimated by combining step one and step two data ranged from 17% in Italy to 29% in Belgium with an overall value of 23%. This large-scale study confirms that allergic rhinitis has a high prevalence in western Europe and is frequently undiagnosed.

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Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20).

Alexander L. Richards, Jay Piccirillo, G Merritt (2001)

A valid measure of rhinosinusitis health status and quality of life is required for the complete assessment of treatment effectiveness. The purpose of this study was to analyze the psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20), a disease-specific, health-related quality-of-life measure for rhinosinusitis. The SNOT-20 is a modification of the 31-Item Rhinosinusitis Outcome Measure, and it contains 20 nose, sinus, and general items. To complete the instrument, patients indicate how much they are affected in each area and identify the 5 most important items. The SNOT-20 was completed by 102, 72, and 46 patients at the initial visit and at 6 months and 1 year after treatment commencement, respectively. Cronbach's alpha was 0.9; test-retest scores were highly correlated (r = 0.9). Patients who were more affected had greater SNOT-20 scores (P < 0.002), and patients who had improved had greater change scores (P < 0.04). Items identified as important had greater scores (P < 0.0001) and showed greater change scores (P < 0.0002). The SNOT-20 is a valid outcome measure for patients with rhinosinusitis; it describes the health burden and is sensitive to clinical change.

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Author and article information

Contributors

Vegard Bugten:

ORCID: http://orcid.org/0000-0002-4857-7648

+47 47810611 , vegard.bugten@ntnu.no , vegard.bugten@stolav.no

Ann Helen Nilsen: Ann.Helen.Nilsen@stolav.no

Wenche Moe Thorstensen: Wenche.Moe.Thorstensen@ntnu.no

Mads Henrik Strand Moxness: madsmox@gmail.com

Marit Furre Amundsen: Marit.Furre.Amundsen@stolav.no

Ståle Nordgård: Stale.Nordgard@ntnu.no

Journal

Journal ID (nlm-ta): BMC Ear Nose Throat Disord

Journal ID (iso-abbrev): BMC Ear Nose Throat Disord

Title: BMC Ear, Nose, and Throat Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6815

Publication date (Electronic): 28 October 2016

Publication date PMC-release: 28 October 2016

Publication date Collection: 2016

Volume: 16

Electronic Location Identifier: 13

Affiliations

[1 ]Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, 7006 Trondheim, Norway

[2 ]Department of Ear, Nose and Throat, Head and Neck Surgery, St. Olavs Hospital, Trondheim, Norway

Author information

Vegard Bugten http://orcid.org/0000-0002-4857-7648

Article

Publisher ID: 31

DOI: 10.1186/s12901-016-0031-7

PMC ID: 5084441

PubMed ID: 27799847

SO-VID: b6fc6294-9b08-49e8-a016-e310ca3f409b

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 9 April 2016

Date accepted : 31 July 2016

Funding

Funded by: St Olavs Hospital

Funded by: FundRef http://dx.doi.org/10.13039/100009123, Norges Teknisk-Naturvitenskapelige Universitet;

Custom metadata

ScienceOpen disciplines: Otolaryngology

Keywords: nasal septoplasty,snot,allergic rhinitis,allergy,snoring,obstructive sleep apnea,chronic rhinosinusitis

Data availability:

ScienceOpen disciplines: Otolaryngology

Keywords: nasal septoplasty, snot, allergic rhinitis, allergy, snoring, obstructive sleep apnea, chronic rhinosinusitis

Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals

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Asian Journal of Quality of Life (AjQoL)

Most cited references 13

EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

Prevalence and rate of diagnosis of allergic rhinitis in Europe.

Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20).

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