Outcomes after Nasal Septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) Study
Abstract
Objective Our goal was to assess disease-specific quality of life outcomes after nasal septoplasty in adults with nasal obstruction. Design, settings, and patients We conducted a prospective observational outcomes multicenter study with 14 sites and 16 investigators, including private practice and academic settings. Patients had had septal deviation and symptomatic nasal obstruction for at least 3 months, and medical management had failed. Methods Patients with septal deviation completed a validated outcomes instrument (the Nasal Obstruction Septoplasty Effectiveness [NOSE] scale) before and 3 and 6 months after septoplasty, with or without partial turbinectomy. Results Fifty-nine patients underwent surgery; there was a significant improvement in mean NOSE score at 3 months after septoplasty (67.5 versus 23.1, P Conclusions In patients with septal deformity, nasal septoplasty results in significant improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use.
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Endoscopic surgical treatment is beneficial in patients with chronic rhinosinusitis with nasal polyps who have severe symptoms and do not respond to appropriate medical treatment.
“In CRS with NP , endoscopic surgical treatment has been shown to be beneficial in patients with severe symptoms who do not respond to appropriate medical treatment [20,127,128,212-218] and may be more cost-effective [219,220].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [213]
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“or obstruction 62 (17) 14 (18)‡ 62 (16) 14 (17)‡ 63 ( 15 ) 14 (16)‡ 60 (20) 11 (23)‡ 69 (16) 23 (22)‡ 52 (23) 16 (26)§”
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“Sample size was calculated to detect a reduction of 20 points in NOSE-p score, using the results reported by Stewart et al.17 as reference.”
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“The NOSE is developed to assess nasal obstruction and is validated in adults undergoing septoplasty [16, 27].”
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“It was concluded that in patients with septal deformity, nasal septoplasty results in signifi cant improvement in disease specifi c QOL, high patient satisfaction and decreased medication use [ 8 ].”
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“Its original use was in patients undergoing septoplasty who demonstrated an improvement in disease-specific QOL after surgery.(23) Subsequent studies using the NOSE scale in patients undergoing surgery for NVC also demonstrated statistically significant improvements in disease-specific QOL.”
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“These healthy subjects were non-smokers with no symptoms of nasal obstruction and/or congestion, and all had Nasal Obstruction Symptom Evaluation score of≤30 (Stewart et al., 2004a; Stewart et al., 2004b).”
BackgroundLindsay, R., Bhama, P. K., Hohman, M., & Hadlock, T. (2015) · JAMA Facial Plastic Surgery · doi:10.1001/jamafacial.2014.1295 · Cited by 38 · see citing works
The Upper Airway Nasal Complex: Structural Contribution to Persistent Nasal Obstruction
Williams, R. A., Patel, V., Chen, Y.-F., Tangbumrungtham, N., Thamboo, A., Most, S. P., Nayak, J., & Liu, S. (2019) · Otolaryngology Head & Neck Surgery · doi:10.1177/0194599819838262 · Cited by 37 · see citing works
Predictive factors of patients’ general quality of life after nasal septoplasty
Valsamidis, K., Titelis, K., Karkos, P., Markou, K., Constantinidis, J., & Triaridis, S. (2018) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-018-5229-4 · Cited by 36 · see citing works
Posnick, J., Choi, E., Adachie, A., & Troost, T. (2016) · Journal of oral and maxillofacial surgery · doi:10.1016/j.joms.2015.10.021 · Cited by 36
Antibiotics in Septoplasty: Evidence or Habit?
Ricci, G., & D'Ascanio, L. (2012) · American Journal of Rhinology & Allergy · doi:10.2500/ajra.2012.26.3755 · Cited by 36
Rudmik, L., Mace, J. C., Ferguson, B., & Smith, T. (2011) · The Laryngoscope · doi:10.1002/lary.22361 · Cited by 36 · see citing works
Self-citationManagement of naso-septal deformity in childhood: long-term results.
Dispenza, F., Saraniti, C., Sciandra, D., Kulamarva, G., & Dispenza, C. (2009) · Auris, nasus, larynx · doi:10.1016/j.anl.2009.02.005 · Cited by 36
“For this reason we believe, in accordance with other authors [18,19], that patients subjective feelings is the main outcome measurement of surgery success.”
ResultGrose, E., Holmes, C., Aravinthan, K. A., Wu, V., & Lee, J. M. (2021) · Journal of Otolaryngology - Head and Neck Surgery · doi:10.1186/s40463-021-00507-z · Cited by 35
Malik, J., Li, C.-Y., Maza, G., Farag, A. A., Krebs, J. P., McGhee, S., Zappitelli, G., Deshpande, B., Otto, B. A., & Zhao, K. (2019) · International Forum of Allergy and Rhinology · doi:10.1002/alr.22350 · Cited by 35 · see citing works
Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery
Yamasaki, A., Levesque, P. A., Bleier, B., Busaba, N., Gray, S., Holbrook, E., Sedaghat, A., & Lindsay, R. (2019) · The Laryngoscope · doi:10.1002/lary.27859 · Cited by 35
Outcomes of septorhinoplasty: a new approach comparing functional and aesthetic results.
Radulesco, T., Penicaud, M., Santini, L., Thomassin, J., Dessi, P., & Michel, J. (2018) · International Journal of Oral & Maxillofacial Surgery · doi:10.1016/j.ijom.2017.09.002 · Cited by 35 · see citing works
Endoscopic vs. conventional septoplasty: A review of the literature.
Champagne, C., de Régloix, S. B., Genestier, L., Crambert, A., Maurin, O., & Pons, Y. (2016) · European Annals of Otorhinolaryngology Head and Neck Diseases · doi:10.1016/j.anorl.2015.11.004 · Cited by 35
Silvers, S., Rosenthal, J. N., McDuffie, C., Yen, D. M., & Han, J. K. (2021) · International Forum of Allergy and Rhinology · doi:10.1002/alr.22861 · Cited by 34
Kumar, R. D., & Rajashekar, M. (2016) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-015-0928-2 · Cited by 34 · see citing works
Computed tomography scan does not correlate with patient experience of nasal obstruction
Ardeshirpour, F., McCarn, K., McKinney, A., Odland, R., Yueh, B., & Hilger, P. (2016) · The Laryngoscope · doi:10.1002/lary.25784 · Cited by 34
Self-citationCaughlin, B., Been, M. J., Rashan, A., & Toriumi, D. (2015) · JAMA Facial Plastic Surgery · doi:10.1001/jamafacial.2014.1370 · Cited by 34
“Patients had a mean (range) age of 31 (14-67) years.”
BackgroundClinical assessment is an accurate predictor of which patients will need septoplasty
Sedaghat, A., Busaba, N., Cunningham, M., & Kieff, D. (2013) · The Laryngoscope · doi:10.1002/lary.23683 · Cited by 34
- Authors
- Stewart, M. G., Smith, T. L., Weaver, E. M., Witsell, D. L., Yueh, B., Hannley, M. T., Johnson, J. T., & The Nose Study Investigators
- Affiliations
- Baylor College of Medicine (US)
- Medical College of Wisconsin (US)
- University of Washington (US)
- Duke University (US)
- University of Pittsburgh (US)
- Corresponding author
- Stewart, Michael G.
- Venue
- Otolaryngology–Head and Neck Surgery
- Publisher
- Wiley
- Published
- 2004-03
- Volume
- 130
- Issue
- 3
- Pages
- 283-290
- ISSN
- 0161-6439 (ISSN-L)
- 0194-5998
- 1097-6817
- OpenAlex
- W1972210561
- Cited by
- 514
- References
- 24
- Citations by year
- 2026: 21 · 2025: 24 · 2024: 23 · 2023: 34 · 2022: 30 · 2021: 36 · 2020: 46 · 2019: 35 · 2018: 37 · 2017: 30 · 2016: 22 · 2015: 37 · 2014: 20 · 2013: 20 · 2012: 21
- FWCI
- 6.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Otolaryngology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (K23HL068849, HL068849)
- Topics
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- septoplasty, nasal obstruction, septal deviation, quality of life, NOSE scale, patient satisfaction, turbinate reduction, surgical outcomes
- MeSH terms
- Adult, Female, Humans, Male, Nasal Septum, Nose Diseases, Prospective Studies, Quality of Life, Otorhinolaryngologic Surgical Procedures, Nasal Obstruction, Treatment Outcome
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