ENT Department, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales, UK.
Eur Arch Otorhinolaryngol. 2012 Jan;269(1):113-9. doi: 10.1007/s00405-011-1674-z. Epub 2011 Jun 26.
Septoplasty is a procedure often associated with high levels of patient dissatisfaction post-operatively. This study examined whether rhinospirometry and a modified 'valve-stabilised' technique could pre-operatively predict the outcome of septal surgery and therefore have a role as an objective tool for selection of patients suffering from nasal obstruction due to septal deformity for the procedure of septoplasty. A prospective study was performed of patients attending Singleton Hospital, Swansea, for surgical treatment of nasal obstruction due to septal deformity. Participants were asked to undertake decongested visual analogue scoring (VAS) and rhinospirometric assessment of their nasal obstruction in both normal 'resting' and 'valve-stabilised' nasal positioning. These investigations were undertaken on the day of surgery and 6 weeks post-operatively. Results were converted into nasal partition ratio scores and were assessed statistically for difference, correlation and accuracy. A total of 29 individual participants were included in the study. Septal surgery produced a statistically significant improvement in nasal airflow symmetry in the normal 'resting' nasal position using rhinospirometry (Wilcoxon ranked p > 0.5). This difference was not seen between evaluations in 'valve-stabilised' position (Wilcoxon p < 0.001). No statistical difference was evident between pre-operative 'valve-stabilised' testing and post-operative 'resting position'. The finding was also apparent on VAS nasal assessment. Correlation studies showed a strong relationship between pre-operative 'valve-stabilised' and post-operative 'resting' rhinospirometry results (Spearman's rho = 0. 586, p < 0.002). The strength of this relationship between VAS assessments was less pronounced (Spearman's rho = 0.386 p = 0.07). 'Valve-stabilised' rhinospirometry and VAS appear to be useful pre-operatively to predict the outcome of septal surgery, in terms of airflow symmetry, for nasal obstruction due to septal deformity, with pre-operative 'valve-stabilised' results correlating well with the post-operative standard 'resting' outcomes. Valve-stabilised rhinospirometry may have a role in pre-operatively predicting of likely post-operative patient satisfaction, although further studies are required in this area.
鼻中隔成形术通常与术后患者满意度低有关。本研究旨在探讨鼻呼吸测量和改良的“瓣膜稳定”技术是否可以在术前预测鼻中隔手术的结果，从而作为一种客观工具，用于选择因鼻中隔畸形导致鼻塞的患者进行鼻中隔成形术。对在斯旺西的Singleton 医院因鼻中隔畸形接受手术治疗的鼻塞患者进行了前瞻性研究。参与者被要求在正常“休息”和“瓣膜稳定”鼻位时进行去充血的视觉模拟评分（VAS）和鼻呼吸测量，以评估其鼻塞情况。这些检查在手术当天和术后 6 周进行。结果转换为鼻中隔比评分，并进行统计学差异、相关性和准确性评估。共有 29 名个体参与者纳入研究。使用鼻呼吸测量，鼻中隔手术在正常“休息”鼻位时显著改善了鼻气流对称性（Wilcoxon 等级秩和检验，p > 0.5）。在“瓣膜稳定”位时，这种差异不明显（Wilcoxon，p < 0.001）。术前“瓣膜稳定”测试和术后“休息位”之间没有统计学差异。VAS 鼻部评估也显示了同样的结果。相关性研究显示，术前“瓣膜稳定”和术后“休息”鼻呼吸测量结果之间存在很强的相关性（Spearman 相关系数 = 0.586，p < 0.002）。VAS 评估之间的相关性稍弱（Spearman 相关系数 = 0.386，p = 0.07）。“瓣膜稳定”鼻呼吸测量和 VAS 似乎可以在术前预测鼻中隔手术的结果，用于因鼻中隔畸形导致的鼻塞，预测气流对称性，术前“瓣膜稳定”结果与术后标准“休息”结果相关性良好。“瓣膜稳定”鼻呼吸测量可能在预测术后患者满意度方面具有作用，但这方面需要进一步的研究。
