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Giombi F, Canali L, Zuppardo J, Pace GM, Pirola F, Ferreli F, Mercante G, Spriano G, Cerasuolo M, Malvezzi L. Psychiatric Burden in Chronic Sinonasal Diseases: A Single-Center Cross-Sectional Observational Study. Cureus 2024; 16:e57471. [PMID: 38699136 PMCID: PMC11065418 DOI: 10.7759/cureus.57471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic rhinosinusitis (CRS) and nasal septum deviation (SD) are two widely diffused clinical conditions in otorhinolaryngology clinical practice. Albeit nasal symptoms are the most commonly referred by patients affected by both conditions, recent evidence has explored the impairment of nasal function beyond its local implication. Indeed, the prevalence of psychiatric disorders, specifically anxiety and depression, was found higher in patients suffering from SD or CRS than in the general population. The aim of this study was to evaluate the psychiatric burden of these conditions in terms of anxiety and depression and to assess its relationship with clinical phenotype and age. METHODS Monocentric cross-sectional observational study. Consecutive patients affected by CRS with or without nasal polyps or by SD were considered eligible. At referral, each patient underwent nasal endoscopy for clinical diagnosis and had to fill in the Hospital Anxiety and Depression Scale (HADS), the Sinonasal Outcome Test-22 (SNOT-22), and the Visual Analogue Scale (VAS) for global nasal symptoms. The population was grouped according to disease and age. RESULTS One hundred fifty patients were enrolled. We observed a statistically significant difference in mean HADS score between patients affected by CRS with nasal polyps and those suffering from CRS without nasal polyps or SD both in the overall population and by age groups. Nevertheless, there was no significant difference in the HADS score between younger patients affected by CRS and SD. The mean HADS score was significantly higher in younger patients affected by SD compared to older. Furthermore, we observed an inverse correlation between age and HADS score in each disease group, statistically significant for SD. On the contrary, in the overall population, HADS score and patient-related outcomes (PROs) were directly correlated. Conclusions: In the era of personalized medicine, our work remarks on the critical impact of anxiety and depression on the quality of life (QoL) of patients affected by sinonasal conditions. According to our results, age affects patient-reported outcomes (PROs) and should, therefore, be enhanced in the therapeutic decision process.
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Affiliation(s)
- Francesco Giombi
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Luca Canali
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Jessica Zuppardo
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Gian Marco Pace
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Francesca Pirola
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Michele Cerasuolo
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
- Otorhinolaryngology Head and Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Milan, ITA
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
- Otorhinolaryngology Head and Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Milan, ITA
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Mandour YMH, El Hamshary A, Abdel-Elhay SA, Abdel-Hamid MS, Gomaa M. Laryngeal Changes After Septoplasty and Turbinectomy. Indian J Otolaryngol Head Neck Surg 2023; 75:3242-3247. [PMID: 37974822 PMCID: PMC10645820 DOI: 10.1007/s12070-023-03951-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/08/2023] [Indexed: 11/19/2023] Open
Abstract
Studies found only a little amount of evidence about the impact of septoplasty on the mechanism of voice production, as well as vocal cord and laryngeal mucosal changes. Nasal obstruction is a common medical issue that is linked to changes in the quality of resonance of voice. To assess patients with deviated nasal septum and inferior turbinate hypertrophy's voice alterations using laryngeal stroboscope before and after septoplasty and turbinectomy. In this prospective case-control study, patients in group A had inferior turbinate hypertrophy and a nasal septal deviation, while participants in group B were healthy controls who were matched for age and gender. All of the included patients had their laryngeal stroboscope and acoustic voice characteristics evaluated both preoperatively and three months after surgery. Only the baseline evaluation of healthy controls was done. We included 30 patients with mean age 24.43 ± 7.81 years, and males accounted for two thirds of the included cases, speech testing showed that Amplitude perturbation significantly improved post septoplasty with p values < 0.05, while Fundamental frequency and NHR parameters didn't show statistically significant improvement compared to preoperative measurements and control groups. Paired comparison of laryngeal erythema, mucosal edema and mucosal waves showed significant improvement compared to preoperative laryngeal stroboscopic findings with p values < 0.001 each. Significant improvements were made to septal deviation following surgery nasal obstruction caused by nasal septal deviation and inferior turbinate hypertrophy is associated with amplitude perturbation, laryngeal erythema, mucosal edema, and mucosal waves in the patients.
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García-Chabur MA, Castellanos J, Corredor-Rojas G, Salgar M, Moreno S, Pinzón M, Peñaranda A. Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study. Int Arch Otorhinolaryngol 2023; 27:e266-e273. [PMID: 37125370 PMCID: PMC10147458 DOI: 10.1055/s-0042-1743462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/16/2021] [Indexed: 02/16/2023] Open
Abstract
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.
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Affiliation(s)
- María A. García-Chabur
- Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
- Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
| | - Juliana Castellanos
- Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
| | | | - Mariana Salgar
- Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
| | - Sergio Moreno
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
| | - Martín Pinzón
- Department of Otorhinolaryngology, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
- Department of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
| | - Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Department of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Otolaryngology Research group, UNIMEQ-ORL, Bogotá, Colombia
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Adult Cleft Patients: An Exploration of Functional Needs and Treatment Barriers. J Craniofac Surg 2023; 34:332-336. [PMID: 35984002 DOI: 10.1097/scs.0000000000008931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/07/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Management of cleft lip and palate has been well characterized in pediatric patients, but limited data exist regarding the long-term functional outcomes of cleft patients once they reach adulthood. MATERIALS AND METHODS An institutional, cross-sectional survey of adult patients with a history of cleft lip and/or palate was performed. The survey recorded patient characteristics, concerns, and barriers to care. Patient-reported outcome measures were assessed using the Nasal Obstruction Symptom Evaluation Scale, Epworth Sleepiness Scale, Mandibular Function Impairment Questionnaire, and the CLEFT-Q Speech Modules. RESULTS A total of 63 patients (18.2%) participated in the survey. The mean patient age was 43.7 years (median: 41 y, range: 19-93 y), and the most common diagnosis was cleft lip and palate (51%) followed by isolated cleft palate (35%) and isolated cleft lip (14%). A subset of patients scored with moderate to severe dysfunction on each outcome measure including the Nasal Obstruction Symptom Evaluation Instrument (59%), Epworth Sleepiness Scale (7%), and Mandibular Function Impairment Questionnaire (13%). Respondent scores on the CLEFT-Q Speech modules demonstrated a bimodal distribution with lower scores in a significant subset of patients with cleft palate and cleft lip and palate. Many respondents (41%) were interested in clinical evaluation but cited barriers to seeking treatment including financial barriers (35%) or lack awareness of clinical options (27%). CONCLUSIONS Many cleft patients have persistent needs or concerns in adulthood, especially regarding speech and nasal breathing. Systemic barriers pose challenges to these patients undergoing clinical evaluation.
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Quality of Life and Symptoms Before and After Nasal Septoplasty With or Without Turbinoplasty Compared With Control Individuals in Saudi Arabia. J Craniofac Surg 2022; 34:922-925. [PMID: 36730854 PMCID: PMC10128898 DOI: 10.1097/scs.0000000000009115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Nasal septal deviation is a common health issue that can significantly impact the quality of life. Although nasal septoplasty is commonly performed in Otolaryngology practice, its effectiveness has been questioned. This was the first study to assess disease-specific quality of life in patients undergoing nasal septoplasty with or without turbinoplasty in Saudi Arabia. METHODS This was a prospective observational study of patients undergoing nasal septoplasty with or without turbinoplasty for nasal obstruction due to septal deviation with or without inferior turbinate hypertrophy. Nasal Obstruction Symptom Evaluation (NOSE) scores were collected preoperatively and 3 months postoperatively and were compared with controls. RESULTS This study involved 200 subjects, including 40 patients in the case group and 160 individuals in the control group. The mean preoperative and 3-month postoperative NOSE scores of the case group were (58.4±23.7 and 15.0±18.6, P<0.001), respectively. However, the postoperatively NOSE score did not reach NOSE score in control group (13.28±8.13, P=0.377). All nasal symptoms statistically and clinically improved postoperatively. There were no significant differences in NOSE score changes among cases preoperatively and postoperatively according to age, sex, or the presence of allergic rhinitis or asthma. CONCLUSIONS Nasal septoplasty with or without turbinoplasty leads to improvements in disease-specific quality of life as assessed by NOSE scores and significantly improved nasal symptoms 3 months after surgery.
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Han KD, Park SH, Son S, Kim SH, Kim I, Kim JY, In SM, Kim YS, Lee KI. Relationship between Chronic Rhinosinusitis and the Incidence of Head and Neck Cancer: A National Population-Based Study. J Clin Med 2022; 11:jcm11185316. [PMID: 36142963 PMCID: PMC9506370 DOI: 10.3390/jcm11185316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 11/25/2022] Open
Abstract
We analyzed the relationship between chronic rhinosinusitis (CRS) and the incidence of head and neck cancers (HNCs) in a Korean adult population. This retrospective cohort study included data from the Korean National Health Insurance Service database. Adjustments were made to minimize risk variables for sex, age, diabetes, hypertension, dyslipidemia, and rhinitis between the two groups. The primary endpoint was newly diagnosed HNC between January 2009 and December 2018. Among 1,337,120 subjects in the Korean National Health Insurance Service database, data from 324,774 diagnosed with CRS (CRS group) and 649,548 control subjects (control group) were selected. Patients with CRS exhibited a statistically significant greater risk for nasal cavity/paranasal sinus cancer, hypopharynx/larynx cancer, and thyroid cancer compared with the control group. In the CRS group, the adjusted hazard ratios for nasal cavity/paranasal sinus cancer were 1.809 (95% confidence interval (CI) 1.085–3.016), 1.343 (95% CI 1.031–1.748) for hypopharynx and larynx cancer, and 1.116 (95% CI 1.063–1.173) for thyroid cancer. CRS was associated with a higher incidence of HNCs. Therefore, physicians should carefully consider the possibility of HNC progression and implement therapeutic strategies to minimize the impact of these diseases.
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Affiliation(s)
- Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 03080, Korea
| | - Sang-Hyun Park
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul 03080, Korea
| | - Sumin Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Seung-Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Ikhee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Jong-Yeup Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
- Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Seung-Min In
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Yeon-Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
| | - Ki-Il Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Korea
- Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Korea
- Correspondence: ; Tel.: +82-42-600-6845
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Alessandri-Bonetti M, Costantino A, Gallo Afflitto G, Carbonaro R, Amendola F, Catapano S, Cottone G, Borelli F, Vaienti L. Anxiety and depression mood disorder in patients with nasal septal deviation: A systematic review and meta-analysis. Am J Otolaryngol 2022; 43:103517. [PMID: 35714499 DOI: 10.1016/j.amjoto.2022.103517] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nasal septal deviation (NSD) is one of the most prevalent upper airway diseases causing airway obstruction, and it can negatively impact patients' quality of life (QoL). OBJECTIVE The aim of this study was to determine the risk of anxiety and depression mood disorders in patients with NSD. METHODS A systematic review and meta-analysis was performed according to the PRISMA statement. An electronic search was performed on PubMed/MEDLINE, Scopus and Google Scholar. Raw affect size data were pooled comparing standardized between group mean differences. RESULTS A total of 625 patients (males: 53 %, n = 280/525) with a mean age of 32.4 years (n = 375, 95 % CI: 25.3-39.4) were included. The pooled standardized mean differences (SMD) for the prevalence of the anxiety disorder was 1.17 (n = 625, 95 % CI: 0.34-2.0). The pooled SMD for the prevalence of the depression disorder was 0.30 (n = 490, 95 % CI: 0.12-0.48). CONCLUSION Prevalence of anxiety and depression mood disorders is higher in patients with NSD compared to controls. These diseases should be investigated and considered during the diagnostic and therapeutic process to improve the QoL of patients with NSD.
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Affiliation(s)
- Mario Alessandri-Bonetti
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Riccardo Carbonaro
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Francesco Amendola
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Simone Catapano
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Giuseppe Cottone
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Francesco Borelli
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Luca Vaienti
- Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
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Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Niedzielski A. A review of health-related quality of life issues in children suffering from certain key otolaryngological illnesses. Front Pediatr 2022; 10:1077198. [PMID: 36714651 PMCID: PMC9875050 DOI: 10.3389/fped.2022.1077198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The health-related quality of life (HRQoL) concept is nowadays increasingly and more broadly used for helping evaluate the effectiveness of medical treatment, superseding the earlier "quality of life" approach. The HRQoL concept likewise applies to otolaryngology and this narrative review study is focused on HRQoL outcomes in four key childhood otolaryngological diseases as reported in the literature. STUDY AIM To retrospectively evaluate the literature on measuring HRQoL in children suffering from selected otolaryngological illnesses, during treatment. MATERIALS AND METHODS Published studies/case reports were searched for in Medline, PubMed, Web of Science, Scopus and ORCID on the quality of life based on paediatric patient questionnaires, whether completed by subjects themselves or by their parents (by proxy). The following key words were used: health quality of life, otolaryngology/ENT, pediatrics/paediatrics. Studies before 1999 were omitted because hitherto, the "quality of life" had been imprecisely defined thus rendering any subsequent comparisions problematic. RESULTS HRQoL scores and well-being were found to significantly deteriorate in child patients suffering from four important otolaryngological disorders: chronic sinusitis, nasal septum deviation, adenoid hypertrophy and hearing disease. The main problems found were infection, inflammation, disruption to family life and child-parental interaction, fitness-related issues, reduced ENT patencies and apnea. CONCLUSIONS The HRQoL appears to significantly deteriorate in children suffering from otolaryngological diseases. Further such studies are needed for other ENT diseases.
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Affiliation(s)
- Lechosław Paweł Chmielik
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
| | | | - Anna Kasprzyk
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
| | - Artur Niedzielski
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Pediatric ENT, The Children's Hospital in Dziekanów Leśny, Dziekanów Leśny, Poland
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Avrunin OG, Nosova YV, Abdelhamid IY, Pavlov SV, Shushliapina NO, Bouhlal NA, Ormanbekova A, Iskakova A, Harasim D. Research Active Posterior Rhinomanometry Tomography Method for Nasal Breathing Determining Violations. SENSORS 2021; 21:s21248508. [PMID: 34960601 PMCID: PMC8708127 DOI: 10.3390/s21248508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
This study analyzes the existing methods for studying nasal breathing. The aspects of verifying the results of rhinomanometric diagnostics according to the data of spiral computed tomography are considered, and the methodological features of dynamic posterior active rhinomanometry and the main indicators of respiration are also analyzed. The possibilities of testing respiratory olfactory disorders are considered, the analysis of errors in rhinomanometric measurements is carried out. In the conclusions, practical recommendations are given that have been developed for the design and operation of tools for functional diagnostics of nasal breathing disorders. It is advisable, according to the data of dynamic rhinomanometry, to assess the functioning of the nasal valve by the shape of the air flow rate signals during forced breathing and the structures of the soft palate by the residual nasopharyngeal pressure drop. It is imperative to take into account not only the maximum coefficient of aerodynamic nose drag, but also the values of the pressure drop and air flow rate in the area of transition to the turbulent quadratic flow regime. From the point of view of the physiology of the nasal response, it is necessary to look at the dynamic change to the current mode, given the hour of the forced response, so that it will ensure the maximum possible acidity in the legend. When planning functional rhinosurgical operations, it is necessary to apply the calculation method using computed tomography, which makes it possible to predict the functional result of surgery.
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Affiliation(s)
- Oleg G. Avrunin
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
- Correspondence: (O.G.A.); (D.H.); Tel.: +380-505980086 (O.G.A.); +48-815384313 (D.H.)
| | - Yana V. Nosova
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
| | - Ibrahim Younouss Abdelhamid
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
| | - Sergii V. Pavlov
- Department of Biomedical Engineering, Vinnytsia National Technical University, 21021 Vinnytsia, Ukraine;
| | - Natalia O. Shushliapina
- Department of Otorhinolaryngology, Stomatological Faculty, Kharkiv National Medical University, 61022 Kharkiv, Ukraine;
| | - Natalia A. Bouhlal
- Azov Maritime Institute, National University “Odessa Maritime Academy”, 65000 Odessa, Ukraine;
| | - Ainur Ormanbekova
- Faculty of Information Technology, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, Almaty 050040, Kazakhstan;
| | - Aigul Iskakova
- Institute of Automation and Information Technologies, Satbayev University, Satpaev Street 22, Almaty 050000, Kazakhstan;
| | - Damian Harasim
- Faculty of Electrical Engineering and Computer Science, Institute of Electronic and Information Technologies, Lublin University of Technology, 20-618 Lublin, Poland
- Correspondence: (O.G.A.); (D.H.); Tel.: +380-505980086 (O.G.A.); +48-815384313 (D.H.)
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Feng D, Yang Y, Liu J, Ke X, Shen Y, Zhang Y, Huang J. Short report: nasal obstruction recovery after septoplasty in patients with nasal septal deviation affected by anxiety and depression. PSYCHOL HEALTH MED 2021; 27:1627-1636. [PMID: 34749562 DOI: 10.1080/13548506.2021.2002378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This research was aimed to explore whether the recovery of subjective symptoms and objective examination in nasal septum deviation (NSD) patients after septoplasty were related to the degree of preoperative anxiety or depression, in the hope of providing new ideas for clinical treatment. A total of 150 NSD patients were included in this prospective research. Visual analogue scale (VAS) scores, Nasal Obstruction Symptom Evaluation (NOSE) scores, self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, total inspiratory and expiratory nasal resistance were recorded before and 6 months after operation. The results showed preoperative anxiety or depression was not statistically different between groups in terms of age, gender and course, but positively correlated with nasal obstruction (VAS and NOSE). The recovery of nasal obstruction in patients with anxiety or depression was worse than that in normal NSD patients 6 months after surgery, and was decreased with the increase of anxiety or depression degree. And no significant difference showed in the reduction of total inspiratory and expiratory nasal resistance between groups. In conclusion, anxiety and depression affected the improvement of nasal obstruction feeling in NSD patients after septoplasty, and the improvement was negatively correlated with the degree of anxiety and depression. It is necessary to evaluate the anxiety and depression of NSD patients before septoplasty.
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Affiliation(s)
- Dandan Feng
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yucheng Yang
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Liu
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xia Ke
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Shen
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Zhang
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiangju Huang
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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11
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Lee KI, In SM, Kim JY, Hong JY, Han KD, Kim JS, Jung YG. Association of nasal septal deviation with the incidence of anxiety, depression, and migraine: A national population-based study. PLoS One 2021; 16:e0259468. [PMID: 34735521 PMCID: PMC8568183 DOI: 10.1371/journal.pone.0259468] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background & aims Nasal obstruction caused by nasal septal deviation is very bothersome and, therefore, can affect the patient’s emotional state. However, little is known about the effect of nasal septal deviation (NSD) on the neuropsychiatric aspects of patients. Therefore, this study aims to verify the higher incidence of anxiety, depression, and migraine in patients diagnosed with NSD compared to general populations using big data. Methods This retrospective cohort study collected subjects from the Korean National Health Insurance Service (NHIS) database. Adjustments were made to minimize the confounding of variables for age, sex, residence type, income levels, hypertension, diabetes, dyslipidemia, rhinitis, and chronic rhinosinusitis between the two groups. The primary endpoint of this study was newly diagnosed anxiety, depression, and migraine between January 2009 and December 2018. Kaplan-Meier survival curves, logarithmic rank test, and Cox proportional regression test were used for statistical analysis. Results Among a total of 135,769 subjects in the NHIS database, 48,495 patients with NSD (NSD group) and 54,475 control subjects (control group) were selected. Patients with NSD had an increased risk of anxiety, depression, and migraine compared to the control group. In the NSD group, the adjusted hazard ratios (HR) were 1.236 (95% CI, 1.198–1.276) for anxiety, 1.289 (95% CI, 1.238–1.343) for depression, and 1.251 (95% CI, 1.214–1.290) for migraine. Conclusion NSD is associated with a higher incidence of anxiety, depression, and migraine. Therefore, it is suggested that physicians carefully consider psychoneurological distress and employ therapeutic strategies to minimize these conditions.
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Affiliation(s)
- Ki-Il Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea
- Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Seung Min In
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Jong-Yeup Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea
- Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Jee-Young Hong
- Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jung-Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yong Gi Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail:
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Pfaff MJ, Bertrand AA, Lipman KJ, Shah A, Nolan I, Krishna V, Patel H, Roostaeian J, Lee JC. The Effect of Functional Nasal Surgery on Olfactory Function. Plast Reconstr Surg 2021; 147:707-718. [PMID: 33620941 DOI: 10.1097/prs.0000000000007667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Functional and aesthetic nasal operations are some of the most common plastic surgery procedures performed in the United States. The purpose of the study was to evaluate the effects of septoplasty, septorhinoplasty, and rhinoplasty procedures on postoperative olfactory function and their relationship to nasal airflow and quality of life. METHODS A systematic review and meta-analysis was performed evaluating olfactory function following nasal surgery. Preoperative and postoperative values for olfaction, nasal airflow, and quality of life/nasal symptoms were analyzed. The effect size was calculated from each study and used for meta-analysis. As studies evaluated patients at different points in the postoperative period, the latest time point reported by each study was used in the meta-analysis. The 95 percent confidence interval of the effect size was calculated for each study. Study quality was assessed using the Jadad and Methodological Index for Nonrandomized Studies instruments. All included studies were Level of Evidence II. RESULTS There were 25 included studies. Following nasal surgery, patients experienced significant improvements in olfaction (p < 0.001), nasal airflow (p < 0.001), and quality of life/nasal symptoms (p < 0.001). Patients often experienced a transient decrease in olfaction immediately after surgery, followed by improvement postoperatively. Preoperative olfactory dysfunction rates were low and postoperative dysfunction was equally low. Olfaction improvement was directly correlated with improvement in nasal airflow and quality of life. CONCLUSIONS Functional and aesthetic nasal operations appear to significantly improve olfaction, which is directly correlated with nasal airflow. Some studies report a transient worsening of these measures in the immediate postoperative period, which subsequently improved at later time points.
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Affiliation(s)
- Miles J Pfaff
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Anthony A Bertrand
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Kelsey J Lipman
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Aloukika Shah
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Ian Nolan
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Vikram Krishna
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Harsh Patel
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Jason Roostaeian
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Justine C Lee
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
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Fried J, Yuen E, Zhang K, Li A, Rowan NR, Schlosser RJ, Nguyen SA, Gudis DA. Impact of Treatment for Nasal Cavity Disorders on Sleep Quality: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2021; 166:633-642. [PMID: 34253107 DOI: 10.1177/01945998211029527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the impact of treatment for patients with nasal obstruction secondary to allergic rhinitis (AR) and nasal septal deviation (NSD) on sleep quality. DATA SOURCES Primary studies were identified though PubMed, Scopus, Cochrane Library, and Web of Science. REVIEW METHODS A systematic review was performed by querying databases for articles published through August 2020. Studies were included that reported on objective sleep parameters (apnea-hypopnea index) and sinonasal and sleep-specific patient-reported outcome measures: Rhinoconjunctivitis Quality of Life Questionnaire, Nasal Obstruction Symptom Evaluation, Epworth Sleepiness Scale (EpSS), and Pittsburgh Sleep Quality Index (PSQI). RESULTS The database search yielded 1414 unique articles, of which 28 AR and 7 NSD studies were utilized for meta-analysis. A total of 9037 patients (8515 with AR, 522 with NSD) were identified with a mean age of 35.0 years (35.3 for AR, 34.0 for NSD). Treatment for AR and NSD significantly improved subjective sleep quality. For AR, the EpSS mean difference was -1.5 (95% CI, -2.4 to -0.5; P = .002) and for the PSQI, -1.7 (95% CI, -2.1 to -1.2; P < .00001). For NSD, the EpSS mean difference was -3.2 (95% CI, -4.2 to -2.2; P < .00001) and for the PSQI, -3.4 (95% CI, -6.1 to -0.6; P = .02). CONCLUSION Subjective sleep quality significantly improved following treatment for AR and NSD. There were insufficient data to demonstrate that objective metrics of sleep quality similarly improved.
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Affiliation(s)
- Jacob Fried
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kathy Zhang
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Andraia Li
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York, USA
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Valsamidis K, Printza A, Constantinidis J, Okalidou A, Triaridis S. Nasalance and perceived voice changes in patients undergoing septoplasty and turbinate hypertrophy reduction. Eur Arch Otorhinolaryngol 2021; 279:1899-1910. [PMID: 34125283 DOI: 10.1007/s00405-021-06937-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to investigate the changes in voice nasality after septoplasty and turbinate hypertrophy reduction and to evaluate the effect of these changes on patients' voice-related quality of life. METHODS Sixty patients with nasal obstruction symptoms caused by septal deviation and inferior turbinate hypertrophy who underwent septoplasty and inferior turbinate hypertrophy reduction and 25 healthy controls were included. Active anterior rhinomanometry and acoustic rhinometry were utilized for the evaluation of nasal patency and nasometry was used for quantitative assessment of nasalance. All participants completed validated questionnaires for assessing nasal obstruction symptom severity, psychological status and the impact of voice performance on their quality of life preoperatively and 6 months after septoplasty. RESULTS Patients presented preoperatively statistically significantly lower nasalance scores and higher VHI scores than controls (p < 0.05). Septoplasty and inferior turbinate hypertrophy reduction led to improvement of nasalance for the nasal text and the physical subscale of the VHI scores. Postoperatively, there were no statistically significant differences in nasalance and VHI scores between patients and controls. Significant correlations were found only for the baseline and the postoperative nasalance scores for the nasal text and the total nasal cavity volume (p < 0.05). Postoperatively, patients who presented significant improvement of nasal obstruction symptoms and resolution of stress levels were more likely to positively evaluate the impact of their voice quality on their daily life (OR: 2.32, 95% CI 1.08-5.15, p = 0.041 and OR: 3.06, 95% CI 1.15-7.04, p = 0.038, respectively). CONCLUSION Septoplasty and inferior turbinate hypertrophy reduction may increase the nasal resonance, but in the long term, this change appears not to be significant enough. The severity of nasal obstruction symptoms and psychological status mainly affect the patients' perceptual assessment regarding the effect of voice performance on their quality of life.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Areti Okalidou
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece.
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The Relationship of Preseptoplasty and Postseptoplasty Early Period Comfort Level With Nasal Obstruction, Sleep Quality, and Fatigue Severity: A Prospective Study. J Perianesth Nurs 2021; 36:268-274. [PMID: 33637408 DOI: 10.1016/j.jopan.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/24/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of this study was to compare the comfort level, nasal obstruction, sleep quality, and fatigue of patients with septal deviation preseptoplasty and postseptoplasty. DESIGN A prospective study conducted on 65 patients diagnosed with septal deviation. METHODS The data of the study were collected using an Introductory Information Form, a Short General Comfort Questionnaire, the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, and the Nasal Obstruction Septoplasty Effectiveness Scale. Linear regression was performed to evaluate the extent of the relationship of predictors affecting the comfort level. FINDINGS There was a statistically significant difference between the scores in the preoperative period and postoperative weeks 4 and 12. It was found that patients' use of sleeping medication, nasal obstruction, fatigue, and subjective sleep quality were the primary predictors of comfort levels in the preoperative period. In the postoperative week 4, comfort level predictors were daytime dysfunction and subjective sleep quality. Daytime dysfunction and working conditions were the predictors of comfort level in the postoperative week 12. CONCLUSIONS Many physical problems, such as nasal obstruction, fatigue, and sleep disorders were detected in patients before septoplasty. This study revealed the importance of performing septoplasty before sleep quality reaches a pathologic level or requires a sleep medication.
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Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon. Eur Arch Otorhinolaryngol 2021; 278:3867-3875. [PMID: 33624151 PMCID: PMC8382632 DOI: 10.1007/s00405-021-06696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.
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Fried J, Yuen E, Li A, Zhang K, Nguyen SA, Gudis DA, Rowan NR, Schlosser RJ. Rhinologic disease and its impact on sleep: a systematic review. Int Forum Allergy Rhinol 2020; 11:1074-1086. [PMID: 33275331 DOI: 10.1002/alr.22740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Rhinologic disease can be responsible for systemic symptoms affecting mood, cognition, and sleep. It is unclear whether sleep disturbance in specific rhinologic disorders (chronic rhinosinusitis [CRS], rhinitis, and nasal septal deviation [NSD]) is an obstructive phenomenon or due to other mechanisms. In this review we examine the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcome metrics and draw comparisons to normal controls and patients with known obstructive sleep apnea (OSA). METHODS A systematic review of 4 databases (PubMed, Scopus, Cochrane Library, and Web of Science) was performed. Studies reporting on objective (apnea-hypopnea index [AHI], respiratory disturbance index [RDI], oxygen nadir) and subjective (Epworth Sleepiness Scale [EpSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS]) sleep parameters and disease-specific patient-reported outcome measures (PROMs; 22-item Sino-Nasal Outcome Test [SNOT-22], Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ], Nasal Obstruction Symptom Evaluation [NOSE]) were included. RESULTS The database search yielded 1414 unique articles, of which 103 were included for analysis. Baseline PROMs were at the high end of normal to abnormal for all 3 conditions: EpSS: CRS (9.8 ± 4.0), rhinitis (9.7 ± 4.3), and NSD (8.9 ± 4.6); and PSQI: CRS (11.0 ± 4.5), rhinitis (6.1 ± 3.7), and NSD (8.6 ± 3.5). Objective measures demonstrated a mild to moderate OSA in the studied diseases: AHI: CRS (10.4 ± 11.5), rhinitis (8.6 ± 8.8), and NSD (13.0 ± 6.9). There were significant differences when compared with reported norms in all measured outcomes (p < 0.001). CONCLUSION Sleep quality is impacted by rhinologic (CRS, rhinitis, NSD) disease. There is likely a mild obstructive component contributing to poor sleep, but other contributing factors may be involved.
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Affiliation(s)
- Jacob Fried
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Andraia Li
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Kathy Zhang
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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Law RH, Bazzi TD, Van Harn M, Craig JR, Deeb RH. Predictors of Long-Term Nasal Obstruction Symptom Evaluation Score Stability Following Septoplasty With Inferior Turbinate Reduction. Laryngoscope 2020; 131:E2105-E2110. [PMID: 33141435 DOI: 10.1002/lary.29229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 10/21/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Determine the postoperative Nasal Obstruction Symptom Evaluation (NOSE) score stability between 1 and ≥6 months after septoplasty with inferior turbinate reduction (ITR). Education level and occupation were evaluated to determine their effects on NOSE score stability during the postoperative period. STUDY DESIGN Retrospective case series. METHODS This was a retrospective case series. Patients were included if they underwent septoplasty with ITR for nasal obstruction due to septal deviation and inferior turbinate hypertrophy. NOSE scores were collected preoperatively, and at 1 and ≥6 months postoperatively. Education level and occupation were collected postoperatively via telephone survey. Changes in NOSE scores were compared between the different time points. Education level and occupation were analyzed to determine if they affected NOSE scores. RESULTS There were 98 patients included, and 56 were male (57.1%). Mean NOSE scores preoperatively and at 1 and ≥6 months postoperatively were 72.1, 17.1, and 12.0, respectively. Patients demonstrated a statistically and clinically significant reduction in NOSE score at 1 month (-54.9, P < .001) and at ≥6 months postoperatively (-60.0, P < .001). The mean 6.2-point decrease in NOSE score from 1 to ≥6 months was statistically, but not clinically significant. There were no significant differences in NOSE score changes based on educational level and occupation. CONCLUSIONS Patients achieved statistically and clinically significant reductions in NOSE scores at 1 months, with no clinically significant differences in NOSE scores at ≥6 months, suggesting NOSE score stability between these postoperative time points. Neither education level nor occupation influenced NOSE scores. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2105-E2110, 2021.
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Affiliation(s)
- Richard H Law
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Talal D Bazzi
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Meredith Van Harn
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - John R Craig
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Robert H Deeb
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A
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Samarei R, Mabarian S. A randomised trial comparing the subjective outcomes following septoplasty with or without inferior turbinoplasty. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:277-283. [PMID: 32482570 DOI: 10.1016/j.anorl.2020.01.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/27/2019] [Accepted: 01/06/2020] [Indexed: 11/27/2022]
Abstract
AIMS The surgical management of contralateral inferior turbinate hypertrophy in patients with deviated nasal septum is controversial. In this randomised clinical trial, we aimed to investigate the subjective improvement of nasal symptoms postoperatively in patients undergoing septoplasty with or without inferior turbinoplasty. MATERIAL AND METHODS One hundred and thirty-seven patients with nasal obstruction, who had unilateral septal deviation and compensatory contralateral inferior turbinate enlargement, were randomised into either septoplasty alone arm (n=66) or septoplasty combined with turbinoplasty arm (n=71). Preoperative symptom scores and the subjective perception of the nasal obstruction were compared between two groups of the study using Nasal Obstruction Symptom Evaluation Scale (NOSE) and Visual analog scale (VAS) respectively. The measurements were repeated 6 months after surgery as well as at 1, 2, and 4 years postoperatively. RESULTS With regard to the findings obtained from both scales, both interventions successfully relieved the patients' complaints of nasal obstruction at almost all postoperative visits when compared with the baseline measurements (P˂0.005 for most comparisons). However, the relief of nasal obstruction was more pronounced in patients undergoing combined intervention at all postoperative visits, except at the 1st follow-up session (P˂0.005). Nasal symptoms of septoplasty alone group began to deteriorate over the period between month 24 and month 48. In contrast, patients undergoing the combined surgery steadily showed symptomatic improvement over the whole period of study. CONCLUSIONS A turbinate reduction surgery should be conducted along with septoplasty to achieve better results in cases suffering from deviated nasal septum with concomitant hypertrophied inferior turbinate.
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Affiliation(s)
- R Samarei
- Department of Otolaryngology, Urmia University of Medical Sciences, Urmia, Iran.
| | - S Mabarian
- Department of Otolaryngology, Urmia University of Medical Sciences, Urmia, Iran
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20
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Ma Q, Su K, Fu Z, Wang P, Shi H. Anxiety and depression in patients with nasal septal deviation. Am J Otolaryngol 2020; 41:102450. [PMID: 32183991 DOI: 10.1016/j.amjoto.2020.102450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Nasal septal deviation (NSD) has a significant impact on patients' quality of life; however, there have been limited studies examining the psychological status of NSD patients. In this study, symptoms of depression and anxiety were investigated between NSD patients and controls using a self-report questionnaire. METHODS A case-control study design was used to evaluate the psychological burden of NSD in patients who visited the general hospital. The control group comprised of ENT outpatients without a history of chronic nasal disease. The Zung Self-rating Anxiety/Depression Scale (SDS/SAS) was used to evaluate the prevalence and severity of anxiety and depression between the NSD and control group. RESULTS Seventy-six patients with NSD and 79 control patients were enrolled in the study. We found that depression and anxiety, as well as the co-morbidity of depression with anxiety, were more common in the NSD group in comparison to the control (39.5% vs 22.8%, p = 0.025; 38.2% vs 15.2%, p = 0.001; and 27.6% vs 11.4%, p = 0.011, respectively). The average SDS and SAS score was higher in NSD patients compared to controls (SDS: 49.7 ± 13.1 vs 45.2 ± 10.4, p = 0.019 and SAS: 48.1 ± 11.6 vs 41.3 ± 9.3, p < 0.001, respectively), and NSD patients were found to have more severe levels of anxiety and depression. CONCLUSION Depression and anxiety are more common and severe in patients with NSD. Therefore, psychological distress should be taken into consideration during the diagnostic and therapeutic process for patients with NSD.
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Staibano P, Bonaparte JP. The relationship between the Ottawa Valve Collapse Scale (OVCS) and clinical outcomes in septoplasty patients. J Otolaryngol Head Neck Surg 2020; 49:14. [PMID: 32178727 PMCID: PMC7074994 DOI: 10.1186/s40463-020-00407-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/25/2020] [Indexed: 11/28/2022] Open
Abstract
The Ottawa Valve Collapse scale (OVCS) was developed to classify the severity of nasal valve collapse (NVC) in patients with nasal obstruction. The goal of this study was to determine, in patients who have nasal obstruction due to a septal deviation, whether those with a higher OVCS grade will have a reduced improvement in patient-centered clinical outcomes at one-year following septoplasty with inferior turbinate diathermy compared to those with a normal or lower OVCS grade. This study was a prospective study of 78 patients who completed an assessment using the NOSE questionnaire before and at one-year following the surgical intervention. A repeated-measures ANOVA was used to asses for differences in scores between OVCS groups. There was a significant improvement in NOSE scores one year post-septoplasty (p < 0.01). There was no difference in NOSE score improvement when comparing the grades of the OVCS at one-year (F = 0.09, p = 0.968). Though the OVCS was designed to categorize the severity of NVC preoperatively, there is no evidence that it is helpful in predicting which patients will demonstrate poor results following septoplasty. Future studies are required to further evaluate the OVCS and whether complimentary assessments will improve its clinical utility.
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Affiliation(s)
| | - James P Bonaparte
- Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, 105A - 460 West Hunt Club Road, Ottawa, ON, K2E 0B8, Canada.
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Valsamidis K, Printza A, Constantinidis J, Triaridis S. The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation. Int Arch Otorhinolaryngol 2020; 24:e237-e246. [PMID: 32296471 PMCID: PMC7153923 DOI: 10.1055/s-0040-1701269] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/03/2019] [Indexed: 01/25/2023] Open
Abstract
Introduction
Olfactory dysfunction may be present in patients with nasal obstruction and septal deviation. The impact of olfactory dysfunction on the psychological profile and quality of life (QoL) of these patients remains unexplored.
Objective
The present study aimed to investigate the emotional status and QoL of patients with olfactory dysfunction and septal deviation and to identify predictors associated with clinically significant improvement of psychological status and QoL, focusing mainly on the role of olfactory recovery after septoplasty.
Methods
The olfactory function was quantitatively assessed using the ‘‘Sniffin’ sticks'' test (Burghart Messtechnik GmbH, Wedel, Germany) in 60 patients and 25 controls enrolled in this prospective study. The participants completed validated questionnaires specific for general health (Short Form-36), nasal-symptom related QoL (SinoNasal Outcome Test-22), olfaction-associated QoL (Questionnaire of Olfactory Deficits) and for assessing their psychological state (Short Anxiety Screening Test and Beck Depression Inventory) preoperatively and 6 months postoperatively. The patients used the Glasgow Benefit Inventory to evaluate their personal benefit after septoplasty with.
Results
Septoplasty led to significantly improved olfactory function. Patients with olfactory impairment had significantly lower nasal-symptom related QoL, higher stress levels, and more depressive mood compared with normosmics and controls before and after septoplasty. Postoperatively, personal benefit from surgery was higher in normosmic patients. Improvement of nasal-symptom related QoL was significantly associated with higher likelihood of clinically significant improvement of patients' psychological profile and more personal benefit from surgery. Olfactory dysfunction was negatively correlated with the emotional status of the patients.
Conclusion
Olfactory dysfunction appears to significantly affect the psychological status of patients with nasal obstruction, and olfactory recovery improves the patients' perception of personal benefit from septoplasty.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
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The Impact of Septoplasty Operation on Odor Threshold Score and Symptom Severity According to the Nasal Septum Deviation Classifications. J Craniofac Surg 2020; 30:2483-2485. [PMID: 31469737 DOI: 10.1097/scs.0000000000005870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The authors aimed to determine the changes in the odor threshold and sinonasal outcome test-22 scores of the patients after septoplasty surgery in terms of nasal septum deviation classifications. METHODS Forty-nine patients with nasal septum deviation, aged between 17 and 65, were included in our study. The sinonasal outcome test-22 scores questionnaire and the N-Butanol Threshold test were administered to the patients, 2 days before and 2 months after the septoplasty. RESULTS The authors' study had 4 major findings: Odor threshold scores improved after septoplasty operation both for the narrower and the wider side of the nasal airway passage. The Vidigal classification for nasal septum deviation was best for predicting the changes for odor threshold scores after septoplasty operation. The nasal septum deviation in which the nasal septum was pushing the inferior turbinate to lateral nasal wall caused the most smell dysfunction according to the Vidigal classification. Unilateral vertical crest affecting the nasal valv area or the posterior part of the septum had the most negative effect on olfactory functions according to the Mladina classification. CONCLUSION Septoplasty operation leads to improvement in odor threshold scores, and the Vidigal nasal septum deviation classification was best in predicting postoperative odor threshold changes.
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Valsamidis K, Printza A, Titelis K, Constantinidis J, Triaridis S. Olfaction and quality of life in patients with nasal septal deviation treated with septoplasty. Am J Otolaryngol 2019; 40:747-754. [PMID: 31345588 DOI: 10.1016/j.amjoto.2019.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/15/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Patients with septal deviation-induced nasal obstruction may experience olfactory impairment. This study aimed to evaluate septoplasty-related changes in olfactory function and their effect on patients' quality of life (QoL). METHODS Prospective study of sixty patients with nasal obstruction and septal deviation and 25 healthy controls. Objective measurements were performed for the evaluation of nasal patency and "Sniffin' sticks" tests were used for quantitative assessment of lateralized and bilateral olfactory performance. All participants self-assessed their smell using a visual analog scale and completed validated questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation: NOSE), for nasal symptoms QoL (SinoNasal Outcome Test-22: SNOT-22), for olfaction-associated QoL (Questionnaire of Olfactory Deficits: QOD) preoperatively and six months after septoplasty and reported personal benefit after surgery (Glasgow Benefit Inventory: GBI), six months postoperatively. RESULTS Smell was significantly compromised due to septal deviation especially in the more obstructed nasal cavity side. Smell improved significantly after septoplasty (subjective report and olfactory measurements), along with increased nasal patency. Increased nasal cavity volume was significantly correlated with olfactory thresholds but not with suprathreshold measurements. Subjective hyposmia and lateralized olfaction were significantly reduced postoperatively. Postoperatively, normosmic patients reported higher personal benefit from surgery than patients with olfactory disorders. The patients' QoL improved significantly, but it remained lower than the controls' group. Olfaction-associated QoL was not significantly different between patients and controls before and after septoplasty. CONCLUSION Septoplasty leads to improvement in smell perception, and patients with improved smell report greater personal benefit from septoplasty than patients with remaining olfactory deficits.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Konstantinos Titelis
- Otolaryngology Department, General Hospital Georgios Gennimatas, Ethnikis Amynis 41, 54635 Thessaloniki, Greece.
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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