Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study

Abstract Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study.

Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Síntomas otorrinolaringológicos asociados con infección positiva de SARS-CoV-2 confirmada con RT-PCR: un estudio de casos y controles en Colombia / Otolaryngological symptoms associated with positive RT-PCR SARS-CoV-2 infection: a case-control study in Colombia

Introducción: las alteraciones otorrinolaringológicas en pacientes con COVID-19 tienen particular importancia a nivel mundial. Sin embargo, todavía no hay consenso en la literatura acerca de la epidemiología, la gravedad y el tiempo de recuperación de estos trastornos. Objetivo: este estudio tiene como objetivo evaluar la asociación entre los síntomas otorrinolaringológicos y la positividad del SARS-CoV-2 confirmada mediante la reacción en cadena de la polimerasa de transcripción inversa (RT-PCR), así como la gravedad, duración y recuperación de estos síntomas en pacientes de la Fundación Santa Fe de Bogotá, un hospital de referencia de COVID-19 en Bogotá, Colombia. Métodos: estudio observacional, prospectivo, tipo casos y controles, realizado entre el 9 de octubre de 2020 y el 14 de enero de 2021. Los casos incluyeron adultos que obtuvieron una prueba positiva para el SARS-CoV-2 mediante RT-PCR. Los casos se emparejaron en una proporción de 2:1 con adultos sintomáticos seleccionados al azar con una prueba negativa, o con pacientes prequirúrgicos. Resultados: se incluyeron 130 casos y 253 controles entre los 10.004 pacientes sometidos a la prueba del SARS-CoV-2. La edad media era de 41,8 años (desviación estándar [DE]: 16,3). Los síntomas otorrinolaringológicos asociados a la positividad al SARS-CoV-2 fueron anosmia/hiposmia (adjusted odds ratio [aOR]: 5,82; intervalo de confianza [IC] del 95 %: 1,92-17,68), disgeusia/hipogeusia (aOR: 9,09; IC del 95 %: 2,86-28,92) y tos seca (aOR: 3,18; IC del 95 %: 1,56-6,48). La duración media de la anosmia/hiposmia y de la disgeusia/hipogeusia en los pacientes con SARS-CoV-2 positivos fue de 14,5 días y 15 días (rango intercuartílico [IQR]: 8-27), respectivamente. Hasta el 70,3 % y el 67,5 % de la población informó de una recuperación completa de la anosmia/hiposmia y la disgeusia/hipogeusia. En cuanto a la gravedad de los síntomas de anosmia/hiposmia y disgeusia/hipogeusia, el 62,1 % y el 65,4 % de la población positiva para SARS-CoV-2 los clasificó como graves. Sin embargo, solo el 6,1 % de ellos recibió tratamiento para estos síntomas. Conclusiones: los síntomas otorrinolaringológicos asociados con la positividad para SARS-CoV-2 son útiles para orientar el diagnóstico, pero establecer sus características clínicas también es esencial para un tratamiento adecuado.

Introduction: Otolaryngological disorders in COVID-19 patients have drawn attention worldwide. However, there is still no consensus regarding the prevalence, severity or recovery of these disorders. This study aimed to assess the association between otolaryngological symptoms and SARS-CoV-2 positivity confirmed by RT-PCR, as well as the severity, duration, and recovery of these symptoms in patients receiving care at Fundación Santa Fe de Bogotá, a COVID-19 referral hospital in Bogotá, Colombia. Methods: Observational, analytic, prospective, case-control study conducted between October 9, 2020, and January 14, 2021. Cases included adults who tested positive for SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR). Cases were matched in a 2:1 ratio with randomly selected symptomatic adults with a negative test, or patients awaiting surgery. Results: Of 10004 patients tested for SARS-CoV-2, 130 cases and 253 controls were included. The mean age was 41.8 years (standard deviation [SD]: 16.3). The otolaryngological symptoms associated with SARS-CoV-2 positivity were anosmia/hyposmia (adjusted odds ratio [aOR]: 5.82; 95% confidence interval [CI]: 1.92-17.68), dysgeusia/ hypogeusia (aOR: 9.09; 95% CI: 2.86-28.92), and dry cough (aOR: 3.18; 95% CI: 1.56-6.48). The median duration of anosmia/hyposmia and dysgeusia/hypogeusia in SARS-CoV-2 positive patients was 14.5 days and 15 days (interquartile range [IQR]: 8-27), respectively. Up to 70.3% and 67.5% of the population reported a complete recovery of anosmia/hyposmia and dysgeusia/hypogeusia. Regarding the severity of anosmia/hyposmia and dysgeusia/hypogeusia symptoms, 62.1% and 65.4% of the SARS-CoV-2 positive population classified them as severe. However, only 6.1% of them received treatment for these symptoms. Conclusions: Otolaryngological symptoms associated with SARS-CoV-2 positivity are a useful guide to diagnosis, although adequate treatment also requires determination of their clinical characteristics.

Nasal Obstruction and Quality of Life Assessment After Septoplasty With Turbinoplasty: Correlation Between Subjective Scales.

BACKGROUND: Assessment of nasal obstruction is imprecise due to a low correlation between findings on the physical examination and objective measures with the severity of symptoms reported by the patient even after septoplasty with turbinoplasty is performed. The aim of this study is to evaluate the use of subjective scales, and the correlation between them for the evaluation of nasal obstruction after surgery. OBJECTIVE: To assess the impact of undergoing septoplasty with turbinoplasty to relieve nasal obstructive symptoms and the quality of life in a mid-term period by using the Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), and Glasgow Benefit Inventory (GBI). METHODS: A retrospective study was conducted of patients who underwent a septoplasty with turbinoplasty due to nasal septodeviation and secondary nasal obstructive symptoms at the Hospital Universitario Fundación Santa Fe de Bogotá. Three scales were used to measure the outcomes one year after surgery: VAS (0-10), NOSE (0-100), and GBI (-100 to 100). RESULTS: Data from 56 patients (21 females, mean age 37.5 years of age, SD 12.13) was collected. The results showed that 75% of the patients had a post-surgical NOSE score below 50 and a VAS score below 6. Regarding the GBI scale, 75% of the patients improved in their quality of life. An inverse proportional correlation was found between the NOSE and GBI scales (rho = -0.3682) (95% CI -0.579 to -0.111), and there was a directly proportional correlation between the NOSE and VAS scales (rho = 0.7440) (95% CI 0.595 to 0.844). CONCLUSION: Subjective measures suggest there was an improvement in nasal obstructive symptoms and quality of life after surgery. Non-anatomical causes such as rhinitis can be confounding factors to consider in subsequent studies. VAS stands out as a possible interchangeable scale with NOSE to measure nasal obstruction in these patients.