Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery
Alisa Yamasaki MD  Patricia A. Levesque BA  Benjamin S. Bleier MD  Nicolas Y. Busaba MD  Stacey T. Gray MD  Eric H. Holbrook MD  Ahmad R. Sedaghat MD, PhD  Robin W. Lindsay MD
First published: 27 February 2019 https://doi.org/10.1002/lary.27859
Presented at the 2018 Triological Society Combined Sections Meeting, Scottsdale, Arizona, U.S.A., January 18–20, 2018.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Abstract
Objectives
To evaluate the long‐term impact of functional septorhinoplasty (SRP) with and without inferior turbinate reduction (ITR) on disease‐specific symptom severity and general health‐related quality of life (QOL).

Study Design
Prospective cohort study at a tertiary referral center.

Methods
Patients undergoing functional SRP with and without ITR were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale to assess severity of nasal obstruction and the EuroQol‐5 Dimension Questionnaire Visual Analog Scale (EQ‐5D VAS) to assess general health‐related QOL preoperatively and at 2, 4, 6, 12, 24, and 36 months postoperatively. Patient demographics, surgical technique, symptom severity, and QOL outcomes were analyzed.

Results
A total of 567 patients were included, with 391 patients undergoing functional SRP alone (54.0% female; mean age 36.0 years [standard deviation (SD):16.2]) and 176 patients undergoing functional SRP with ITR (50.0% female; mean age 35.6 years [SD:13.6]). There was a significant decrease in NOSE and increase in EQ‐5D VAS scores in both groups through at least 24 months postoperatively. Change in NOSE scores was negatively correlated with change in EQ‐5D VAS (r = −0.38, P < 0.01). Compared to patients undergoing SRP, patients also undergoing ITR had a statistically but nonclinically significant improvement in NOSE, with similar trends for EQ‐5D VAS that were not significant.

Conclusion
SRP results in a sustained, long‐term improvement in nasal obstruction based on disease‐specific and general health‐related QOL measures, with incremental improvement in outcomes with addition of ITR. This study provides the foundation for defining health outcomes and the health utility value of surgical interventions that address nasal obstruction.

Level of Evidence
2c

Laryngoscope, 129:1554–1560, 2019