The Quality of Life Assessment With Sinonasal Outcome Test (SNOT-22) in Patients Undergoing Nasal Functional Surgery: Does Turbinate Surgery Influence Outcomes?

Objective This study aimed to assess the improvement of the quality of life (QoL) through the Sinonasal Outcome Test (SNOT-22) questionnaire among patients undergoing septoplasty or septorhinoplasty with and without turbinoplasty and the possible influence of age and sex. Methods We conducted an observational, analytical, prospective cohort study, between 2013 and 2016, involving 99 patients diagnosed with nasal obstruction due to septal deviation and turbinate hypertrophy. The diagnosis, degree of obstruction, sex, and age of the patients were analyzed. Four types of surgery were performed: septoplasty (S), septorhinoplasty (SRP), S plus turbinoplasty (T), and SRP plus T. The QoL was measured using the SNOT-22 questionnaire, before surgery and four months later. The sum of the scores obtained for each of the 22 indicators was calculated, as well as the differences in these values before and after surgery. Shapiro-Wilk normality tests, boxplot charts, t-tests, paired t-tests, and Kruskal-Wallis tests were used to compare the SNOT-22 parameters and covariables. We applied the Poisson multiple regression model to adjust for differences linked to patients' age and sex. Results Most of the patients in our cohort were male. The average SNOT-22 score pre and post-test were 53.59 ± 18.58 and 8.46 ± 9.90 (p = 0.00001), respectively; the differences were significant for each studied surgery. The differences in QoL were significant for each studied surgery and the difference between pre and post-surgery scores was greater for procedures that included turbinoplasty. The comparison between the procedures involving S alone versus S+T reached a significance level (p = 0.053). In the analysis of the different subcomponents of QoL in SNOT-22, sleep function showed the greatest improvement after S+T surgery. The multivariable Poisson regression model revealed that the biggest difference before and after surgery was related to female gender vs. males, and S+T surgeries vs. S-only surgery Conclusions The SNOT-22 questionnaire proved to be useful in assessing the improvement in QoL after nasal surgery. Both septoplasty and functional septorhinoplasty enhance QoL. However, septoplasty combined with turbinoplasty (S+T) results in greater improvements in QoL and sleep function regardless of age, with the most significant improvement observed in women.