Comparison of the Efficacy of Septoplasty with Nonsurgical Management in Improving Nasal Obstruction in Patients with Deviated Nasal Septum – A Randomized Clinical Trial

Abstract

Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven. Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management. Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups. Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p = 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p = 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p = 0.001). Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.

Prevalence and clinical implications of high anterior septal deviation on sinus access: a retrospective cross-sectional study

“…A notable disparity in symptom scores and PNIF values was observed when comparing the improvement in scores between the two groups from baseline to 3 and 6 months. Septoplasty demonstrated superior effectiveness in mitigating nasal obstruction compared to nonsurgical management [15].…”

Long‐Term Outcomes of Septoplasty With or Without Turbinoplasty: A Systematic Review

“…Many studies have shown that septoplasty with or without turbinoplasty is effective in improving symptoms of nasal obstruction, especially when compared to nonsurgical medical treatment. [8][9][10][11] However, most of these studies and nearly all current reviews focus primarily on short-term (<12 months) outcomes. Whether or not these high septoplasty success rates persist years after surgery remains unanswered, as some long-term studies suggest that patient symptoms may worsen again over time.…”

“…Many studies have shown that septoplasty with or without turbinoplasty is effective in improving symptoms of nasal obstruction, especially when compared to nonsurgical medical treatment 8–11 . However, most of these studies and nearly all current reviews focus primarily on short‐term (<12 months) outcomes.…”