Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

Abstract

Objective To objectively identify and quantitate presenting nasal symptoms in patients with a septal perforation using the validated NOSE‐Perf scale. Study Design Case series retrospective review. Methods The medical records from August 2018 through January 2022 of patients at a tertiary care academic center with a septal perforation, and who completed the NOSE‐Perf questionnaire, were reviewed. Perforation symptoms were identified and quantified using the 12‐item NOSE‐Perf scale (score range 0–48). NOSE‐Perf findings were correlated to patient demographics, perforation etiology, and perforation length. NOSE‐Perf scores of patients who pursued treatment were compared with those who did not. Results NOSE‐Perf data were collected from 202 patients. Nasal crusting was noted in 94.1% of patients and was the most severe symptom reported (mean 2.9 of 4.0). Nasal congestion, difficulty breathing, and nasal obstruction followed in prevalence and severity. The mean total NOSE‐Perf score was 23.7. Linear regression analysis demonstrated a weakly negative association of NOSE‐Perf score with patient age and weakly positive association with increasing perforation length. NOSE‐Perf scores were significantly higher in women and in patients pursuing treatment. Conclusion This is the first study to use the validated NOSE‐Perf scale to objectively characterize and establish baseline septal perforation symptomatology. The NOSE‐Perf scale can play a role in the standardization of perforation evaluation and treatment outcomes assessment. Laryngoscope, 133:1315–1320, 2023

Septal Perforation Repair Quality of Life Outcomes Using the Revised 15-item Glasgow Benefit Inventory

“…The NOSE-Perf scale applied to our practice found females to be more symptomatic from their perforations than males. 12 These results suggest a potential for greater improvement for females following treatment. The median GBI-5F score in females was significantly higher than in males.…”

“…We have determined nasal crusting as the predominant symptom afflicting patients with a perforation and preliminary data from the administration of our NOSE-Perf instrument notes improved, but continued, crusting for many patients postoperatively. 12 This finding is likely due, in part, to our practice in the desert. Postoperative symptom resolution would impact a quality of life measurement.…”

“…[7][8][9][10] The recently, developed and psychometrically validated the NOSE-Perf scale is a diseasespecific instrument to identify and quantify symptoms related to perforations. 11,12 The NOSE-Perf instrument focuses on symptom specific outcomes and may facilitate standardization of perforation evaluation.…”

The “fascia taco” for nasal septum perforation closure—A retrospective Cohort study on success rates and patient reported outcomes

“…The limitations of this study include its retrospective, nonrandomized, and nonblinded design as well as its sample size, which although larger than previous studies, was still limited. At the time this study was conducted, data validated questionnaires such as the NOSE‐Perf scale had not yet been published, 40 and as a consequence NOSE‐Perf was not used in this study. This might be a very helpful tool not only to assess an individual patient's symptomatology, but also to compare different strategies for closure techniques.…”

Validated Symptom Outcomes Following Septal Perforation Repair: Application of the NOSE‐Perf Scale

“…1) The NOSE-Perf scale has been applied to our practice to quantitatively characterize and establish a baseline of symptoms associated with perforations. 19 The primary goal of this study was to use the NOSE-Perf scale to measure change in symptoms following perforation repair. Patient demographics, perforation size, and functional rhinologic procedures performed concurrent to repair were investigated to determine whether they had an impact on symptom outcomes.…”