[Nasal comfort and Cottle septoplasty. Prospective acoustic rhinometry study apropos of 102 cases].

Between june 1997 and september 1998, we have prospectively studied a cohort of 102 patients who were referred to ENT consultation. All patients suffered a septal deviation and a syndrome that we call "morphological". All were operated on following the Cottle's septoplasty technique. At pre- and postoperative consultation, patients were asked to answer a questionnaire and a functional evaluation of the nasal air flow was assessed by acoustic rhinometry. We have described a nasal comfort grading that we compare with the objective results as assessed by acoustic rhinometry. Our study did not permit us to find any correlation between nasal comfort and minimal cross sectional area (MCA). But evaluation of the MCA was disturbed by several methodological artifacts. A statistical correlation between the nasal comfort grading and nasal volume in the side of the septal deviation was found. The acoustic rhinometry evaluation elicited two essential observations: the first is the increase of nasal fossae volume of 30% (and, at least, 26% of the MCA). The other is a relative decrease of 45% of nasal mucosa congestion. This study shows that the nasal septum has an essential function in the pathogenesis of the so-called "morphological" functional syndrome. The morphological correction obtained by the Cottle's septoplasty acts upon the nasal vasomotricity in decreasing nasal mucosa congestion and avoid a surgical reduction of the inferior turbinate.