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Objectives: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a symptom-specific quality-of-life questionnaire for patients suffering from nasal obstruction. The instrument is designed specifically for patients with septal deviation and for the evaluation of the outcome of septoplasty. The aim of this study was to validate a Swedish version of the NOSE instrument for use in clinical practice and research.Methods: A Swedish version of the NOSE was tested in a case group consisting of 125 subjects with nasal obstruction (of which 31 underwent septoplasty) and a control group consisting of 65 healthy subjects. Base line data for the case and control groups were used to evaluate face validity, known groups validity, construct validity, internal consistency and factor structure analysis. Fifty participants in both the case groups and control groups were assessed both at baseline and after 2 weeks to evaluate test-retest reliability. The participants who underwent septoplasty were assessed at baseline and after 3-6 months to evaluate responsiveness.Results: The S-NOSE was found to be reliable, valid, and responsive. Both Cronbachs alpha and McDonald Omega coefficients were > 0.7, and the intra class coefficient was 0.942. The S-NOSE scores were significantly correlated with nasal patency VAS in both the case group and the control group (p < .001 and p = .018, respectively). After septoplasty, the mean S-NOSE score were significantly improved (p < .001). Furthermore, the S-NOSE was shown to have excellent and robust psychometric properties.Conclusion: The S-NOSE can be recommended in both clinical practice and research to evaluate the outcome of septoplasty in Swedish-speaking populations. Funding Agencies|Futurum-The Academy of Health and Care in Region Joenkoeping County, Sweden [FUTURUM-803421]; Swedish government [ALFGBG-715771]

Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.

To evaluate validity and reliability of Lithuanian version of Nasal Obstruction Symptom Evaluation Scale (L-NOSE), designed for the assessment of nasal obstruction. Cross-cultural adaptation of L-NOSE was accomplished according to generally accepted methodology. L- NOSE was tested for its reliability, validity, and responsiveness in the group of 50 septoplasty patients and 100 healthy volunteers’ controls. L- NOSE showed good internal consistency (Cronbach’s alpha coefficient 0.796 for test, 0.791 for retest, 0.792 for post-operative group, and 0.817 for control group) scores and high test–retest reliability (r = 0.94, p

Background Rhinoplasty is considered one of the most challenging operations in the plastic surgery. Esthetic or functional reshaping purposes of the nose can be stressing for both surgeon and patient. Different types of graft materials have been used to perform augmentation rhinoplasty. Free diced cartilage (FDC) was recently established in dorsal nasal rhinoplasty for better handling of irregularities as well as contour deficits of dorsal nasal outcomes. The main purpose of the present study is to assess the effectiveness of the use of FDC in dorsal nasal and nasal tip rhinoplasty and evaluation of its advantages and disadvantages using the validated Nasal Obstruction Symptom Evaluation (NOSE) scale and the Rhinoplasty Outcome Evaluation (ROE) questionnaire to assess nasal obstruction and patient satisfaction. Results This prospective study was conducted between March 2018 and December 2019, 20 patients were included and planned for rhinoplasty using FDC to camouflage dorsal and nasal tip deformities. All patients (11males and 9 females) underwent open rhinoplasty through inverted v columellar incision, taken FDC from nasal septum. A statistical significant difference between pre- and post-operative NOSE scores was found (P Conclusion It was found that the FDC technique is an effective method for camouflage and augmentation of nasal dorsum as well as nasal tip in reconstructive and esthetic rhinosurgery for either primary or secondary rhinoplasty.

Introduction The impact of the nasal septum morphology on the severity of obstruction symptoms has not been fully explored. Objective This study aimed to investigate whether the morphology of the deviated nasal septum assessed by computed tomography may explain nasal obstruction severity. Methods The study included 386 patients who were referred to the computed tomography examination of the paranasal sinuses. Patient selection criteria were the absence of facial anomalies, facial trauma, nasal surgery, and sinonasal tumors. Computed tomography images were used to estimate deviated nasal septum prevalence, the prevalence of Mladina's seven types of deviated nasal septum, and to measure the deviated nasal septum angle. Nasal obstruction severity was assessed by the nasal obstruction symptom evaluation, NOSE scale. The relationship between NOSE score, deviated nasal septum morphology, and deviated nasal septum angle was performed by a statistical regression model on the reduced sample of 225 patients. Results The prevalence of deviated nasal septum was 92.7%. Type 7 deviated nasal septum was the most frequent (34.2%) followed by type 5 (26.2%) and type 3 (23.6%). The worst NOSE scores were recorded in the type 2 deviated nasal septum (45.00 ± 28.28). The mean deviated nasal septum angle in patients with nasal obstruction was 8.5° ± 3.24. NOSE scores were not significantly associated with deviated nasal septum types and angles. Conclusion Patients with different types of deviated nasal septum have different NOSE scores. Computed tomography morphology of the deviated nasal septum could not fully explain the severity of nasal obstruction.

Functional and aesthetic results after septorhinoplasty (SRP) are often not clearly demonstrated. There is still an open topic in the literature about analysis of aesthetic, functional results and patients’ satisfaction after SRP. The aim of our study is to determine patients’ satisfaction after SRP and concomitant radiofrequency of the inferior turbinate (RF) regarding nose appearance and improvement of symptoms, using patient reported outcome measures (PROMs). ROE questionnaire and the NOSE scale were used for a retrospective evaluation to assess patient’s satisfaction in 369 patients undergoing SRP surgery from 2003 to 2016. Two additional questions were asked to confirm satisfaction following surgery. 258 patients completed the questionnaires (71.7%). The global average ROE score was 18.14 (75.6%). The percentage of satisfaction of aesthetic result was 87.3%, in particular 10.5% were very happy, 57% very much satisfied and 19.8% moderately satisfied. The global post-operative average NOSE score was 13.1 with the resolution of nasal obstruction in 72.1% cases and a marked improvement in 9.3%. The results of the two additional questions showed that 81% of patients would undergo the procedure again if required and 72.1% of patients were globally satisfied. Our study demonstrates the utility of PROMs in evaluating aesthetic and functional results after SRP and simultaneous RF. In our series, the patients undergoing SRP and RF are generally satisfied by the functional and aesthetic results. This kind of assessments should be the most common post-operative evaluation methods in this surgery.

Objectives The objective of this study was to investigate the relationship between side asymmetry in nasal resistance (NR) and severity of the nasal airway obstruction (NAO) in patients with different types of nasal septal deformity (NSD). Design Computational fluid dynamics (CFD) study. Setting The study was conducted in a tertiary medical centre. Participants The study included 232 patients, who were referred to the CT examination of the paranasal sinuses. Exclusion criteria were sinonasal and respiratory diseases that may interfere with the nasal obstruction. The presence and the type of NSD were recorded according to the Mladina's classification. Main outcome measures The presence and severity of NAO in each patient were assessed by NOSE questionnaire. Eight computational models of the nasal cavity were created from CT scans. Models represented seven Mladina's NSD types and a straight septum of a symptomless patient. CFD calculated airflow partitioning and NR for each nasal passage. Side differences in NR were calculated by the equation increment NR = NRleft - NRright. The relationship between NOSE scores, airflow partitioning and side differences in NR was explored using Spearman's correlation analysis. Results Mladina's types of NSD showed differences in airflow partitioning and the degree of side asymmetry in NR. A significant positive correlation was detected between side differences in NR and NOSE scores (R = .762, P = .028). A significant negative correlation was found between the per cent of unilateral airflow and NR (R = -.524, P = .037). Conclusions Our results demonstrated that side asymmetry in NR could explain differences in NAO severity related to the NSD type., This is the peer-reviewed version of the article: Janović, N.; Cocić, A.; Stamenić, M.; Janović, A.; Đurić, M. Side Asymmetry in Nasal Resistance Correlate with Nasal Obstruction Severity in Patients with Septal Deformities: Computational Fluid Dynamics Study. Clinical Otolaryngology 2020. [https://doi.org/10.1111/coa.13563]

We aimed to find out whether snoring relieve with nasal surgery in patients with nasal obstruction. Sixty-four patients who underwent septoplasty under general anesthesia with complaint of nasal obstruction and snoring at Haydarpasa Numune Education and Research Hospital were enrolled in the study. All patients were evaluated by otolaryngological examination. Septal deviation was graded as mild, moderate and severe with endoscopy. Variables examined included age, sex, body mass index. All patients also completed the questionnaires, including Nose Obstruction Symptom Evaluation scale (NOSE), Epworth Sleepiness Scale (ESS), and Snore Symptom Inventory (SSI) before and after septoplasty. NOSE scale, ESS, and SSI scores showed statistically significant improvement after nasal surgery (p 0.05). Added to this, the association between body mass index (BMI) and improvement in scores of NOSE scale, ESS, and SSI did not reach statistical significance (p > 0.05). Our results demonstrated that septoplasty is effective on the subjective parameters of nasal obstruction in habitual snorers irrespective of the nasal septal deviation and severity of BMI. © 2014, Springer-Verlag Berlin Heidelberg.

BACKGROUND The efficiency of nasal surgeries can be determined by objective or subjective methods. We have assessed the effect of nasal obstruction after different nasal surgeries using Acoustic Rhinometry (AR) and Nasal Obstruction Symptom Evaluation (NOSE) Scale. METHODS Between May 2011 and May 2012, 40 young adult patients and 10 healthy volunteers as control group who referred to Otorhinolaryngology Clinic in Eskisehir Military Hospital due to nasal obstruction were enrolled. Depending on operation, patients were divided into four equal groups. Group 1: Septoplasty, Group 2: Septoplasty with sprader graft, Group 3: Septorinoplasty and Group 4: Septorhinoplasty with spreader graft. The patients completed NOSE scale, 1 week before and 1 month after the surgery and AR measurements. RESULTS There were a significant improvement in mean NOSE scores of patients and statistical difference was found between pre and post-operational values for each group. There was a statistically significant change of the mean minimal cross section areas (MCA) of the deviated side of nasal passages measured by AR between pre and postoperative period. CONCLUSION In patients with nasal obstruction, functional nasal surgeries which were performed after appropriate medical examination and with right operation methods had a positive impact on quality of life and patient satisfaction. We observed that nasal findings were correlated with NOSE scores and MCA values. So, we suggest that NOSE scale and AR to be used for evaluation of the efficiency of functional nasal surgeries.

SIMSEK, GOKCE/0000-0001-5281-0986 WOS: 000340257800077 PubMed: 24911600 Various methods of surgical treatment are defined in nasal deformities that cause nasal obstruction. Open technique septorhinoplasty is a method that is frequently used for this purpose. This study aims to compare surgical results of open technique septorhinoplasty operations with and without osteotomies. In addition, changes in the quality of life of patients before and after treatment were investigated, and the effects of the 2 methods on patients' quality of life were compared. Methods: Patients with nasal deformity were included in the study. Forty patients with wide nasal dorsum and a prominent hump underwent septorhinoplasty with lateral osteotomy (group 1), and 35 patients with a narrow nasal dorsum and a minimal hump underwent septorhinoplasty without osteotomy (group 2). A Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate disease-specific quality of life for patients in both groups. Basic characteristics, operative parameters, and preoperative and postoperative NOSE scores were compared between the groups. Results: Demographic properties of the groups were similar. Intraoperative parameters and postoperative complications were not different between the groups, with the exception of operation time (which was significantly longer in group 1) and ecchymosis (which was seen in whole cases of group 1 and none of the group 2). Preoperative NOSE scores were similar in both groups. Postoperative NOSE scores were 5 (0-45) in group 1 and 10 (0-45) in group 2 (P > 0.05). The NOSE scores were significantly decreased after the operation in both groups (P < 0.001). The 2 groups were not significantly different when comparing the change in preoperative and postoperative NOSE scores. Conclusions: Rhinoplasty with or without osteotomy is an effective treatment for alleviating nasal obstruction symptoms. Osteotomy is an integral but not obligatory part of the operation. The addition of the osteotomy procedure in selected cases prolonged the operation time and significantly enhanced patient satisfaction.