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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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“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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Aging as the Impact Factor on Septoplasty Success
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“The etiology of nasal obstruction can vary such as septal deviation, turbinate hypertrophy, concha bullosa, nasal polyps, and other sinonasal disorders.(2,3) Septal deviation is the most frequent cause of nasal dysfunction and nasal blockage.”
BackgroundNumerical simulation and nasal air-conditioning
Keck, T., & Lindemann, J. (2011) · GMS current topics in otorhinolaryngology, head and neck surgery · doi:10.3205/cto000072 · Cited by 14
“Septoplasty has a clear benefit on the subjective nasal patency [132], [133].”
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Effect of allergic rhinitis on nasal obstruction outcomes after functional open septorhinoplasty.
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Long-term Outcomes of Subtotal Septal Reconstruction in Rhinoplasty
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“The Nasal Obstruction SymptomEvaluation (NOSE) questionnaire is a validated quality-of-life instrument that canbe routinelyused tohelpquantify nasal breathing outcomes after intervention in the absence of pure objectivemeasurements.(19,20) The rhinoplasty surgeon should also critically analyze his or her aesthetic res…”
Patient‐specific aided surgery approach of deviated nasal septum using computational fluid dynamics
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Characterizing Olfactory Dysfunction in Patients with Unilateral Cleft Lip Nasal Deformities
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“19,20 Anterior rhinomanometry was performed to measure nasal airflow and resistance using the NR6 Clinical/Research Rhinomanometer (GM Instruments Ltd., Kilwinning, Scotland, United Kingdom); measurements were performed with the standard (75 Pa) technique.”
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“The scale has been shown to be a valid disease-specific measure of quality of life for evaluating nasal airway obstruction [6-8].”
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“While some studies, such as those by Stewart 11 and Uppal 37 , found no significant difference between septoplasty with or without turbinate reconstruction, Hong 38 reported better outcomes with combined surgery one-month post-operation, though the difference was no longer significant at three and six months.”
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“3 Computed tomography (CT) is widely used in the preoperative assessment of patients with chronic sinusitis.”
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“Previous studies have reported that the symptomatic improvement rate varies between 70% and 98% among the different surgical techniques for septoplasty (10-16).”
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“Additionally, high patient satisfaction and decreased medication use was also reported.(8) Mondina et al investigated the septoplasty patient’s satisfaction using NOSE and RhinoQOL scores.”
MethodAssessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool
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“Given the lack of correlation found between objective and subjective nasal obstruction outcome measures, clinical consensus [20] has focused on assessing the efficacy of nasal breathing interventions on patient-reported outcome measures such as the Visual Analogue Scale [11], Nasal Surgical Questionnaire [21], Nasal O…”
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“However, many cases of septal deviation are asymptomatic, and the degree or severity of deviation has little to no correlation with the degree of obstruction [2, 3].”
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Ziai, H., & Bonaparte, J. (2018) · Journal of Otolaryngology - Head and Neck Surgery · doi:10.1186/s40463-018-0259-x · Cited by 10
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“The Nasal Obstruction Symptom Evaluation (NOSE) is one of the most highly used scoring systems [5].”
Method"NOSE"Validação em Português e aplicação na septoplastia
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Patel, P., Wadhwa, H., Okland, T., Kandathil, C., & Most, S. P. (2021) · Facial Plastic Surgery & Aesthetic Medicine · doi:10.1089/fpsam.2021.0054 · Cited by 9
“4,17 A similar analysis of the SCHNOS has not been previously done.”
Trigeminal endonasal perception - an outcome predictor for septoplasty.
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“In a great part of the patients a significant improvement in nasal symptoms (1) and quality of life (2) can be achieved.”
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Evaluation of Nasal Obstruction in Various Sagittal Skeletal Deformity of Jaws
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Value-Based Analysis of Routine Pathologic Septal and Inferior Turbinate Specimens
Daniero, J., Chu, J. S., O'Hara, B., & Pribitkin, E. (2013) · Otolaryngology Head & Neck Surgery · doi:10.1177/0194599812472656 · Cited by 9
“In the absence of adenoid hypertrophy and nasal polyposis, septoplasty and turbinectomy have been shown to result in a significant improvement in nasal airflow and quality of life.(1,2) According to the National Center for Health Statistics, more than 196,000 turbinectomies and 260,000 nasal septoplasties were perform…”
BackgroundFunctional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal
Naguib, M., Ahmed, M., Madian, Y., Elnahriry, T., & Eldeeb, W. (2020) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-020-00058-6 · Cited by 8
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Preoperative characteristics of over 1,300 functional septorhinoplasty patients
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Effects of early postoperative nasal decongestant on symptom relief after septoplasty
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Nasal Obstruction and Unilateral Chronic Otitis Media: Evaluation by Acoustic Rhinometry
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“Age, y 32 (13) Sex (female) 27 (61) Trauma history 15 (34) Nasal tip Wide, broad 23 (52) Overprojected 17 (39) Underrotated 35 (79.”
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“Various methods, including acoustic rhinometry, rhinomanometry, and PSCT, are used for the objective evaluation of nasal obstruction [23, 24].”
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Patient-Reported Outcomes Measures in Rhinoplasty: Need for Use and Implementation
Warinner, C. B., Loyo, M., Gu, J., Wamkpah, N., Chi, J., & Lindsay, R. (2023) · Facial Plastic Surgery · doi:10.1055/s-0043-1769806 · Cited by 7
Guvenmez, O., Zhanbaeva, A., Keskin, H., & Zhanbaev, A. (2023) · Cureus · doi:10.7759/cureus.35758 · Cited by 7
“On the other hand, submucous turbinate resection is a less invasive technique, but it still poses a 14% risk of complications such as bleeding [14].”
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Efficiency of modified Goldman’s technique in open pediatric septoplasty
Sabry, O., Dewidar, H., Aziz, M. A., Elemam, A. M., & Nassar, A. (2021) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-021-00074-0 · Cited by 7
“[6] and a 10-cm visual analogue scale (VAS) for subjective assessment of severity of nasal obstruction and its impact on quality of life.”
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Spreader Graft in Closed Rhinoplasty: The “Rail Spreader”
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“Nasal obstruction is reported to be one of the most common complaints in nasal and sinus diseases [6,7].”
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“10,11,14 This can be useful, and even necessary, when the structural integrity of the native caudal septal cartilage is lacking.”
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BackgroundEffectiveness of Septoplasty in Releiving Nasal Obstruction in Patients with Deviated Nasal Septum
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“20 In clinic 1 week after surgery, permanent sutures were removed and the patients rated the pain of the visit on a 0–10 scale.”
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In-office Functional Nasal Surgery.
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Severe deviated nose treatment: importance of preserving the dorsal septal remnant
Sazgar, A. A., Teimouri, Y., Arjang, S., Amali, A., & Most, S. P. (2019) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-019-05321-y · Cited by 6
Ross, E. E., & Anari, S. (2018) · The Journal of Laryngology & Otology · doi:10.1017/s002221511800035x · Cited by 6
Nilsen, A. H., Thorstensen, W. M., Helvik, A., Nordgaard, S., & Bugten, V. (2018) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-018-5022-4 · Cited by 5
Nose blowing after endoscopic sinus surgery does not adversely affect outcomes
Ayoub, N., Chitsuthipakorn, W., Nayak, J., Patel, Z., & Hwang, P. (2018) · The Laryngoscope · doi:10.1002/lary.26907 · Cited by 5
Sen, I., Dutta, M., Haldar, D., & Sinha, R. (2017) · Ear, nose, & throat journal · doi:10.1177/014556131709600212 · Cited by 5
Sowerby, L., & Wright, E. D. (2013) · International Forum of Allergy and Rhinology · doi:10.1002/alr.21209 · Cited by 5
Quality of life after septal surgery
Khambaty, Y., Hasnain, S., Musani, M. A., Javed, I., & Khan, F. (2012) · Journal of Clinical Medicine and Research · doi:10.5897/jcmr11.036 · Cited by 5
“Res. have been used to include the nasal obstruction septoplasty effectiveness study (NOSE) (Stewart et al., 2004), the sinonasal outcome test (SNOT) (Buckland et al., 2003), the Fairlay nasal symptom score (Arunachalam et al., 2001) and the nasal health survey (Seigel et al., 2000).”
MethodLarrabee, W. (2008) · Archives of Facial Plastic Surgery · doi:10.1001/archfacial.2007.6 · Cited by 5
Janović, N., Marić, G., Dusanovic, M., Janovic, A., Pekmezović, T., & Djuric, M. (2020) · Vojnosanitetski Pregled · doi:10.2298/vsp180619130j · Cited by 5
Assessment of Functional and Aesthetic Results in Preservation and Structural Rhinoplasty
Krzywdzińska, S., Jurkiewicz, D., & Jadczak, M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15041429 · Cited by 4
“Stewart et al. [5] developed the NOSE questionnaire in 2004 to assess nasal obstruction symptoms.”
Prevalence of Nasal Airway Obstruction in an Orthodontic Population Using the NOSE Scale
Petts, R., Ponsky, D., de Menezes, L. M., Elshebiny, T., Wolf, K., & Palomo, J. M. (2025) · Orthodontics and Craniofacial Research · doi:10.1111/ocr.70004 · Cited by 4
“Stewart and colleagues found that following septoplasty, the minimal detectable change was 3.9–5.9 points, which helps determine clinical significance [19].”
Influentialde Sousa, M. M., Rebelo, J., Martins, S., Silveira, H., Órfão, T., & Pinto-Moura, C. (2023) · Cureus · doi:10.7759/cureus.38558 · Cited by 4
Alanazy, S., AlQuniabut, I., Alenezi, M., Almutairi, H., Almutairi, A., Altheyab, F., & Al-Wutayd, O. (2022) · The Journal of craniofacial surgery (Print) · doi:10.1097/scs.0000000000009115 · Cited by 4
Malik, J., Otto, B. A., & Zhao, K. (2022) · Current Otorhinolaryngology Reports · doi:10.1007/s40136-021-00387-x · Cited by 4
Our Septoplasty Results: Evaluation with the Nose Scale
Karamese, O., Berçin, A., Muderris, T., & Kırış, M. (2021) · The Journal of craniofacial surgery (Print) · doi:10.1097/scs.0000000000008361 · Cited by 4
“This validated scale has been used to evaluate the effectiveness of septoplasty with or without turbinate surgery for the treatment of nasal obstruction.(10) Although the scale is poor in terms of physical and anatomical findings, it is quite useful for demonstrating the success of a treatment and helping clinicians a…”
MethodThe Inferior Turbinate: Role in Normal Respiration and Airway Obstruction
Thamboo, A., Ayoub, N., Maul, X., & Nayak, J. (2021) · Current Otorhinolaryngology Reports · doi:10.1007/s40136-021-00370-6 · Cited by 4
Mehel, D., Yemiş, T., Çelebi, M., Can, E., Özdemir, D., Ünal, A., & Özgür, A. (2020) · Brazilian Journal of Otorhinolaryngology · doi:10.1016/j.bjorl.2020.07.004 · Cited by 4
Metadata
- 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 (medical) › 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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