Analysis of Outcomes After Functional Rhinoplasty Using a Disease-Specific Quality-of-Life Instrument

Abstract

To measure the efficacy of functional rhinoplasty techniques with a validated quality-of-life instrument. Design: Prospective observational outcomes study of patients with severe nasal obstruction owing to septal deviation, internal or external valve collapse, and turbinate hypertrophy who subsequently underwent functional rhinoplasty. Preoperative and postoperative evaluations were performed using the Nasal Obstruction Symptoms Evaluation scale. Results: Forty-one patients completed preoperative and postoperative evaluations. No complications occurred. There was a significant improvement in mean Nasal Obstruction Symptoms Evaluation score postoperatively for the entire cohort (PϽ.01). Nasal Obstruction Symptoms Evaluation scores were also examined based on the procedure performed, such as spreader grafting, septoplasty, external valve suspension, and turbinectomy. Each subgroup also demonstrated airway improvement. Conclusions: Functional rhinoplasty techniques are effective in improving nasal airway function as measured by a patient-based, disease-specific, quality-of-life instrument. The specific techniques considered to treat nasal obstruction can be tailored to address the areas of concern, including septal deviation, internal or external valve collapse, and turbinate hypertrophy.

Nasal Airway Preservation Using the Autospreader Technique

“…All of these patients had adjunctive procedures performed such as septoplasty, inferior turbinate reduction, and/or bone anchored suture technique. 8 Preoperative NOSE scores for these patients was comparable to that of prior studies 4,5 and were significantly higher than the cosmetic-only group (57. …”

“…The NOSE scale is a disease-specific QOL instrument that has been used extensively to measure the effectiveness of septoplasty, turbinate reduction, anterior septal reconstruction, and other functional procedures including repair of nasal valve stenosis. 4,5,7,9,10 Using this measure, we demonstrate that autospreader grafts are effective in the prevention of postoperative nasal airway obstruction in patients undergoing cosmetic rhinoplasty with dorsal hump takedown.…”

Computed nasal resistance compared with patient-reported symptoms in surgically treated nasal airway passages: A preliminary report

“…The NOSE scale is a quality-of-life instrument specifically designed for NAO that has been validated for septoplasty and functional rhinoplasty 28,29 and used recently as a primary outcome measure of surgical success. 30,31 Patients are asked to rate, over the past month, their feelings of (1) nasal congestion or stuffiness, (2) nasal blockage or obstruction, (3) trouble breathing through the nose, (4) trouble sleeping, and (5) ability to get enough air through the nose during exercise or exertion on a 0-4 scale with 0 ϭ not a problem, 1 ϭ very mild problem, 2 ϭ moderate problem, 3 ϭ fairly bad problem, and 4 ϭ severe problem. Each score is multiplied by 5 and when the 5 scores are added together, total scores of 0 and 100 represent the best and worst cases, respectively.…”

Contemporary Review of Rhinoplasty

“…Using the NOSE instrument, Most 24 conducted a prospective study of 41 patients to assess the efficacy of functional rhinoplasty techniques in improving diseasespecific quality of life. Selected patients had nasal obstruction for at least 1 year as the result of an identifiable anatomic cause, including septal deviation, turbinate hypertrophy, and internal or external valve collapse.…”