Disease-Specific Vs Non-Specific Questionnaires on Septoplasty Outcomes

Document Type : Original


Department of Otorhinolaryngology, Vila Nova de Gaia / Espinho Hospital Center, Portugal.


Validated questionnaires are a valuable tool in medical practice. The role of septoplasty in improving patients’ non-nasal symptoms and their quality of life is still controversial. The aim of this study was to determine the differences in outcome after septoplasty measured by a disease-specific questionnaire vs a general QoL questionnaire.
Materials and Methods:
A total of 50 patients underwent septoplasty and completed the SNOT-22 and the SF-36v2 questionnaires preoperatively and at 6 months post-op. Pre-op, post-op and variation for each domain in both questionnaires were calculated and compared with a measure of self-reported health transition (Question 2 of SF-36v2) and with the Minimal important difference (MID) for our sample.
SNOT-22 scores significantly improved for each specific question and for the total score. SF-36v2 showed a significant improvement in scores for mental domains (Mental Health, Role Emotional, and Vitality) but less so for the physical domains. MID for our sample was 4.2 points. Patients with variations greater than 4.2 in SNOT-22 total score (74%) revealed significantly better variations in Physical Function, General Health, Social Function and Vitality.
Validated questionnaires are a fundamental tool for assessing outcomes of commonly performed surgeries in ENT. Disease-specific questionnaire showed improvement in scores for the majority of patients. The general QoL showed improvement only in Mental Domains. This may suggest that the impact of septoplasty in patient’s general health might not be significant.


  1. Gray LP. Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Suppl. Published online 1978.
  2. Hatipoglu HG, Cetin MA, Yuksel E. Nasal septal deviation and concha bullosa coexistence: CT evaluation. B-ENT. Published online 2008.
  3. van Egmond MMHT, Rovers MM, Hannink G, Hendriks CTM, van Heerbeek N. Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: a pragmatic, randomised controlled trial. Lancet. Published online 2019. doi:10.1016/S0140-6736(19)30354-X
  4. 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. Published online 2004. doi:10.1016/j. otohns. 2003.12.004
  5. Valsamidis K, Titelis K, Rachovitsas D, Konstantinidis I, Markou K, Triaridis S. Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate Cauterization for the Treatment of Nasal Obstruction using Objective and Subjective Methods. Int Arch Otorhinolaryngol. Published online 2018. doi:10.1055/s-0037-1613688
  6. Arunachalam PS, Kitcher E, Gray J, Wilson JA. Nasal septal surgery: Evaluation of symptomatic and general health outcomes. Clin Otolaryngol Allied Sci. Published online 2001. doi:10.1046/j. 0307-7772.2001.00481.x
  7. Erdivanli OC, Coskun ZO, Ozgur A, Ogurlu M, Demirci M, Dursun E. Comparison of Quality of Life Before and After Septoplasty With Short Form-36. J Craniofac Surg. 2020;31(3):832-835. doi:10. 1097/SCS.0000000000006358
  8. Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. Published online 2009. doi:10.1111/j.1749-4486. 2009.01995.x
  9. Buckland JR, Thomas S, Harries PG. Can the Sino-nasal Outcome Test (SNOT-22) be used as a reliable outcome measure for successful septal surgery? Clin Otolaryngol Allied Sci. Published online 2003. doi:10.1046/j.1365-2273. 2003. 00663.x


  1. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (Sf-36): I. conceptual framework and item selection. Med Care. Published online 1992.doi:10.1097/00005650-199206000-00002
  2. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. Published online 2016. doi:10.1177/2050312116671725
  3. Ribeiro J, Nogueira S. SNOT-22: a life quality score questionnaire in Portuguese patients with Chronic Rhinosinusitis. [master thesis]. Faculdade de Medicina da Universidade de Coimbra; 2018
  4. Ferreira PL. Creation of Portuguese version of the MOS SF-36 Part I, Cultural and Linguistic Adaptation. Acta Med Port. Published online 2000. doi:10.20344/amp.1760
  5. Atlas SJ, Gallagher PM, Wu YA, et al. Development and validation of a new health-related quality of life instrument for patients with sinusitis. Qual Life Res. Published online 2005. doi:10. 1007/s11136-004-6674-7
  6. H.S.Satish DHSS. Septoplasty Outcome Using Snot- 22 Questionnaire Study. IOSR J Dent Med Sci. 2013;6(5):34-38. doi:10.9790/0853-0653438
  7. Hytönen ML, Lilja M, Mäkitie AA, Sintonen H, Roine RP. Does septoplasty enhance the quality of life in patients? Eur Arch Oto-Rhino-Laryngology. Published online 2012. doi:10.1007/s00405-012-1931-9
  8. Pannu KK, Chadha S, Kaur IP. Evaluation of benefits of nasal septal surgery on nasal symptoms and general health. Indian J Otolaryngol Head Neck Surg. Published online 2009. doi:10.1007/s12070-009-0036-2
  9. Samad I, Stevens HE, Maloney A. The efficacy of nasal septal surgery. J Otolaryngol. Published online 1992.
  10. 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 Oto-Rhino-Laryngology. Published online 2019. doi:10.1007/s00405-018-5229-4
  11. Naraghi M, Amirzargar B, Meysamie A. Quality of Life Comparison in Common Rhinologic Surgeries. Allergy Rhinol. Published online 2012. doi:10.2500/ar.2012.3.0020