Our Summary

This study evaluated how effective a surgical procedure known as septoplasty is, in comparison to medical management (using a nasal steroid and saline spray) for adults with a deviated nasal septum. This condition often causes nasal obstruction, which can disrupt normal breathing.

The study was carried out in 17 clinics across the UK’s National Health Service and involved 378 adults. Half of these adults were randomly chosen to receive the septoplasty surgery, while the other half received the nasal steroid and saline spray treatment for six months.

The researchers used a scoring system called the Sino-Nasal Outcome Test-22 (SNOT-22) to measure patients’ symptoms before and after treatment. A higher score indicates more severe symptoms. After six months, they found that the average score for the surgical group was about 20 points lower (better) than the medical treatment group. This means that the surgery was more effective at reducing symptoms.

The surgery also improved quality of life and nasal airflow more than the medical management. However, there were some side effects. Seven participants (4%) had to be readmitted to the hospital due to bleeding after the surgery, and 20 participants (12%) needed antibiotics for infections.

In conclusion, the study suggests that septoplasty surgery is a more effective treatment for adults with a deviated nasal septum than using a nasal steroid and saline spray.

FAQs

  1. What is septoplasty and what condition does it treat?
  2. How did the study measure the effectiveness of septoplasty compared to medical management?
  3. What were the side effects of the septoplasty surgery as observed in the study?

Doctor’s Tip

If you are considering septoplasty, it is important to discuss the potential benefits and risks with your doctor. They may advise you on how to prepare for the surgery, what to expect during the recovery period, and how to minimize the risk of complications. Remember to follow your doctor’s instructions carefully to ensure a successful outcome.

Suitable For

Patients who are typically recommended for septoplasty are adults with a deviated nasal septum causing nasal obstruction and disruption of normal breathing. Symptoms may include difficulty breathing through the nose, snoring, frequent sinus infections, and facial pain. These patients may have tried conservative treatments such as nasal steroids and saline spray without significant improvement in their symptoms. Septoplasty may be recommended for patients who have persistent symptoms and impaired quality of life due to their nasal obstruction.

Timeline

Before septoplasty:

  1. Patient experiences symptoms such as nasal obstruction, difficulty breathing, and reduced quality of life.
  2. Patient may try medical management with nasal steroid and saline spray to alleviate symptoms.
  3. Patient undergoes evaluation by an ear, nose, and throat specialist to determine if septoplasty is necessary.

After septoplasty:

  1. Patient undergoes septoplasty surgery to correct the deviated nasal septum.
  2. Patient experiences some side effects such as bleeding and infection, which may require readmission to the hospital or antibiotics.
  3. Patient’s symptoms gradually improve over time.
  4. Patient’s quality of life and nasal airflow improve significantly compared to before the surgery.
  5. Patient’s symptoms are monitored using the Sino-Nasal Outcome Test-22 to assess the effectiveness of the treatment.

What to Ask Your Doctor

Some questions a patient should ask their doctor about septoplasty include:

  1. What are the potential risks and complications associated with septoplasty surgery?
  2. How long is the recovery period after septoplasty surgery?
  3. Will I need to stay in the hospital after the surgery, or is it done on an outpatient basis?
  4. What type of anesthesia will be used during the surgery?
  5. How long will it take for me to see improvement in my symptoms after the surgery?
  6. Will I need to follow any specific post-operative care instructions?
  7. Are there any restrictions on activity or diet after the surgery?
  8. How long do the results of septoplasty typically last?
  9. What are the alternatives to septoplasty for treating a deviated nasal septum?
  10. Are there any long-term implications or risks associated with undergoing septoplasty surgery?

Reference

Authors: Carrie S, O’Hara J, Fouweather T, Homer T, Rousseau N, Rooshenas L, Bray A, Stocken DD, Ternent L, Rennie K, Clark E, Waugh N, Steel AJ, Dooley J, Drinnan M, Hamilton D, Lloyd K, Oluboyede Y, Wilson C, Gardiner Q, Kara N, Khwaja S, Leong SC, Maini S, Morrison J, Nix P, Wilson JA, Teare MD. Journal: BMJ. 2023 Oct 18;383:e075445. doi: 10.1136/bmj-2023-075445. PMID: 37852641