What, if any, is the value of septal surgery?

Roblin, D. G.; Eccles, Ronald

doi:10.1046/j.1365-2273.2002.00531.x

Cited by 70 publications

(69 citation statements)

References 32 publications

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“…Despite the fact that the prevalence of nasal septal deviation reaches up to 80%, only a minority of affected individuals suffer from nasal obstruction (10). For this reason, we used the NOSE questionnaire, which is a specific and reliable tool to evaluate nasal obstruction in adults (8,9).…”

Section: Discussionmentioning

confidence: 99%

Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?

Kaya

Dağlı²,

Kırat

2018

Turk Arch Otorhinolaryngol

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Objective: Our aim is to evaluate the effect of nasal septal deviation on the middle ear pressure and Eustachian Tube (ET) functions with regard to the side of deviation. Methods:A prospective randomized clinical trial was conducted. Overall, 50 patients (22 female, 28 male) undergoing septoplasty because of nasal septum deviation were included. The nasal obstruction symptom evaluation (NOSE) scale was used to evaluate surgical satisfaction. Middle ear ventilation and the ET functions of a total of 100 ears were assessed with basal tympanometry and insufflation tests (Valsalva and Toynbee). The tests were performed on the operation day and eight weeks after surgery. The ears were divided into two groups: the affected side (the side of nasal obstruction) (Group 1) and the contralateral side (Group 2). The study parameters obtained before and after septoplasty were compared. Results:The NOSE scores decreased after septoplasty (12.48±4.78/7.56±3.4) (p<0.001). There were 20 functional ETs (40%) in the affected side preoperatively, which increased to 36 ears (72%) postoperatively, and functional tubes increased to 35 (70%) from 29 (58%) after surgery in the contralateral side. The changes in the tympanometry results were statistically significant for both the affected side (−33.56 daPA/−21.18 daPA) and contralateral side (29.24daPA /−24.96daPA) (p<0.05), but the alteration in the side of deviation was more evident. Conclusion:Our study shows that septoplasty may have a beneficial effect on middle ear ventilation and ET functions.

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Section: Discussionmentioning

confidence: 99%

Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?

Kaya

Dağlı²,

Kırat

2018

Turk Arch Otorhinolaryngol

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“…Since SD is so commonly observed as an anatomic variation in healthy adults, clinicians must often decide whether or not a septal deviation is clinically relevant to NAO (Calhoun et al, 1991;Min et al, 1995;Jones et al, 1997;Robin and Eccles, 2002). Surgical correlation of septal deviations has been one of the most common procedures in otolaryngology, but, the objective evidence to support the efficacy of surgery is controversial.…”

Section: Models Of Nasal Airflow In Septal Deviation Pathologiesmentioning

confidence: 99%

Patient specific CFD models of nasal airflow: Overview of methods and challenges

Kim

et al. 2013

Journal of Biomechanics

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“…The estimated prevalence of a deviated septum ranges up to 80%, whereas only a minority suffers from nasal obstruction. It has been questioned whether straightening the septum provides any benefit to those patients, and if so, which patients benefit most . Professional associations of ENT‐surgeons have called for further research, but RCTs comparing septoplasty with non‐surgical management are still unavailable…”

Section: Introductionmentioning

confidence: 99%

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

Egmond¹,

Rongen²,

Hedeman³

et al. 2018

Clinical Otolaryngology

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Objective The objective of this study was to demonstrate how decision‐analytic modelling can help to determine circumstances under which surgery may become cost‐effective, using septoplasty as an example. Design We developed a decision‐analytic model comparing septoplasty to non‐surgical management for nasal obstruction in adults with a deviated septum. Based on the estimated cost difference between both treatments, we calculated the minimal (a) gain in quality‐adjusted life‐years, or (b) reduction in productivity losses needed for septoplasty to be cost‐effective. Input was derived from literature and publicly available data sources. The time horizon of our model was one year, and the willingness‐to‐pay per quality‐adjusted life‐year was €20 000, in accordance with current guidelines. Results The cost difference between septoplasty and non‐surgical management for nasal obstruction due to a deviated nasal septum was €2227 per patient from a healthcare perspective (including direct healthcare costs) and €3288 per patient from an extended perspective (additionally including travel expenses and productivity losses due to poor health). In comparison with non‐surgical management, septoplasty needed to gain 0.11 to 0.16 QALYs or save 13 sick days for nasal obstruction. The longer septoplasty's effect lasts, the more time it will have to compensate its extra costs. Conclusion This study shows that the known cost difference between treatments can be used as the starting point to determine beneficial effects needed for cost‐effectiveness of surgical interventions. The effect required by septoplasty from a healthcare perspective seems potentially achievable, meaning that it would be useful to perform an RCT assessing the actual benefits of septoplasty.

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What, if any, is the value of septal surgery?

Cited by 70 publications

References 32 publications

Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?

Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?

Patient specific CFD models of nasal airflow: Overview of methods and challenges

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost‐effectiveness

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