Evaluation of Nasal Obstruction Following Septoturbinoplasty Using the VAS and NOSE Scale

Document Type : Original

Authors

1 Catholic University of Saint Anthony (Spain)

2 Department of Ear, Nose and Throat. Hospital Rafael Méndez, Lorca, Spain.

10.22038/ijorl.2023.75824.3541

Abstract

Introduction:
Patient satisfaction with septoturbinoplasty was measured using the subjective visual analogue scale (VAS) and Nasal Obstruction Symptom Evaluation (NOSE) scale. In addition, those factors that impacted satisfaction were confirmed.
 
Materials and Methods:
We conducted an observational study of patients who underwent septoturbinoplasty. Age, sex, smoking habit, duration of improvement, postoperative complications, type of packing and surgeon were analysed. The results were compared using the VAS and NOSE scale.
Results:
The improvement experienced with surgery corresponded to 69.80±26.97 points on the VAS 42.65±22.9 points (p <0.01) on the NOSE scale. A strong, direct correlation between the two scales (r = 0.79; p <0.01) was achieved. Surgeon, presence of complications, smoking habit and type of packing were not associated with the improvement experienced on the VAS or NOSE scale. Patients under 30 years of age and patients with permanent improvement achieved higher levels of satisfaction on both scales (p <0.01). Women showed a stronger tendency to perceive their improvement as temporary (p <0.01).
Conclusions:
Patients who underwent septoturbinoplasty experienced a subjectively measured improvement in nasal obstruction. The VAS and the NOSE scale were strongly correlated with one another. Sex, age and duration of improvement (temporary versus permanent) impacted patient perception; surgeon, smoking habit and type of packing did not.

Keywords

Main Subjects


  1. Jessen M, Malm L. Definition, prevalence and development of nasal obstruction. Allergy. 1997; 52(40 Suppl):3-6. doi: 10.1111/j.1398-9995. 1997. tb04876.x.
  2. Bhattacharyya N. Ambulatory sinus and nasal surgery in the United States: demographics and perioperative outcomes. Laryngoscope. 2010 Mar; 120(3): 635-8. doi: 10.1002/lary.20777.
  3. 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.
  4. Tompos T, Garai T, Zemplén B, Gerlinger I. Sensation of nasal patency compared to rhinomanometric results after septoplasty. Eur Arch Otorhinolaryngol. 2010 Dec;267(12):1887-91. doi: 10.1007/s00405-010-1278-z. 
  5. André, R, Vuyk, H, Ahmed, A, Graamans, K Nolst Trenité G. Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clinical Otolaryngology. 2009;34: 518-525.
  6. Hsu HC, Tan CD, Chang CW, Chu CW, Chiu YC, Pan CJ, Huang HM. 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(1):53-59.
  7. Kökoğlu K, Şahin MI. Use of Neutrophil, Eosinophil, Basophil, and Platelet to Lymphocyte Ratio to Predict Patient Satisfaction After Septoplasty Plus Inferior Turbinate Reduction. J Craniofac Surg. 2019;30(4):1022-1026.
  8. 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(2):429-438.
  9. 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 Dec;38(6):528-535. doi: 10.14639 /0392-100X-2072.
  10. Rhee JS, Sullivan CD, Frank DO, Kimbell JS, Garcia GJ. A systematic review of patient-reported nasal obstruction scores: defining normative and symptomatic ranges in surgical patients. JAMA Facial Plast Surg. 2014 May-Jun;16(3):219-25; quiz 232. doi: 10.1001/jamafacial.2013.2473.
  11. Pedersen L, Schiöler L, Holmberg K, Ahlström Emanuelsson C, Hellgren J. Age and Unplanned Postoperative Visits Predict Outcome after Septoplasty: A National Swedish Register Study. Int J Otolaryngol. 2018 Jan 2;2018:2379536. doi: 10.1155/2018/2379536.
  12. 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. 2017 May-Jun;68(3):145-150. English, Spanish. doi: 10.1016/j. otorri. 2016.06.007. 
  13. Bezerra TF, Stewart MG, Fornazieri MA, Pilan RR, Pinna Fde R, Padua FG, Voegels RL. Quality of life assessment septoplasty in patients with nasal obstruction. Braz J Otorhinolaryngol. 2012;78(3): 57-62.
  14. Shukla RH, Nemade SV, Shinde KJ. Comparison of visual analogue scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) score in evaluation of post septoplasty patients. World J Otorhinolaryngol Head Neck Surg. 2020;6(1):53-58.
  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(2): 176-80.
  16. Kahveci OK, Miman MC, Yucel A, Yucedag F, Okur E, Altuntas A. The efficiency of Nose Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation. Auris Nasus Larynx. 2012;39(3):275-9.
  17. Mondina M, Marro M, Maurice S, Stoll D, de Gabory L. Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol. 2012;269(10):2189-95.
  18. Eccles R. Objective evidence for the efficacy of surgical management of the deviated septum as a treatment for chronic nasal obstruction: a systematic review. Clin Otolaryngol. 2011 Apr;36(2):106-13. doi: 10.1111/j.1749-4486.2011.02279.x.
  19. Arrington-Sanders R, Yi MS, Tsevat J, Wilmott RW, Mrus JM, Britto MT. Gender differences in health-related quality of life of adolescents with cystic fibrosis. Health Qual Life Outcomes. 2006 Jan 24;4:5. doi: 10.1186/1477-7525-4-5.
  20. Cetiner H, Cavusoglu I, Duzer S. The effect of smoking on perforation development and healing after septoplasty. Am J Rhinol Allergy. 2017 Jan 1;31(1):63-65. doi: 10.2500/ajra.2017.31.4406. 
  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(3):275-84. doi: 10.1007/s12070-015-0928-2.
  22. Karaman M, Tek A. Deleterious effect of smoking and nasal septal deviation on mucociliary clearance and improvement after septoplasty. Am J Rhinol Allergy. 2009 Jan-Feb;23(1):2-7. doi: 10.2500/ajra.2009.23.3253.
  23. Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018 Jul;275(7):1789-1794. doi: 10.1007/s00405-018-4990-8.