A New Approach to the Objective Evaluation of succes of post rhinoplasty nasal septum perforation surgery
Goals/Purpose: Nasal septum perforation is a feared problem after rhinoplasty. There is no an objective evaluation method for NSP surgery. The aim of this study is to propose an evaluation method for NSP surgery.
Methods/Technique: The study was conducted with the six patients with NSP. All NSPs were closed by inferior turbinate flap (ITF). All patients underwent preoperative and postoperative nasal endoscopic examination in order to evaluate septum and mucosal changes (bleeding, crusting…). The Nasal Obstruction Symptom Evaluation (NOSE) 1 instrument was used to evaluate the preoperative and postoperative subjective sensation of nasal obstruction. Measurement of preoperative and postoperative nasal airway resistance was performed with active anterior rhinomanometry (Provair 2 Zan Germany ). The SPSS version 17.0 (SPSS, Inc., Chicago, IL, USA) was used to perform statistical analysis.
Results/Complications: The The full closure of the septal perforations was noted in 100% of patients. The total NOSE score was 14 preoperatively and one for postoperatively. The improvement in NOSE score was statistically significant (p≤ 0.05). The mean preoperative total resistance (ResT150) value was 0,13Pa/cm3s-1, under the normal range (16-31Pa/cm3s-1) . On the other hand, the mean postoperative ResT150 value was measured 0,27Pa/cm3s-1 in normal range. The correlation between the improvement in NOSE score and the improvement in ResT150 value was statistically significant (p≤0.05).
Conclusion: NSP results in double-side problem, anatomical and physiological. Surgical approaches should aim to solve both problems. Application of subjective and objective tests in post operative period will help the surgeon asses the applied technique.
Figure 1. After septal surgery with ITF, nasal resistance reached to normal range.
Figure 2: Spearman's nonparametric correlation test showed a positive correlation between improvement in NOSE scores and ResT150 values.