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Key Points Nasal valve treatment with TCRF results in NAO symptom improvement in the presence of septal deviation. Severe septal deviation does not impact the beneficial effect of TCRF nasal valve treatment. Symptoms improve with TCRF nasal valve treatment even if septal deviations involve the nasal valve. [ABSTRACT FROM AUTHOR]

Background: Improved nasal airway obstruction (NAO) symptoms were reported at 3 months following temperature‐controlled radiofrequency (TCRF) treatment of the septal swell body (SSB). This report provides results from assessments of the long‐term safety and efficacy of TCRF treatment of SSB hypertrophy to treat NAO through 12 months posttreatment. Methods: This prospective, multicenter, long‐term, open‐label study was conducted in nine centers within the United States and included patients with severe/extreme NAO attributed to SSB hypertrophy. Outcome measures included assessments of Nasal Obstruction Symptom Evaluation Score (NOSE), Numeric Rating Scale (NRS) ease‐of‐breathing, patient satisfaction, and adverse events at 6 and 12 months. Results: Of the 70 patients treated, 65 and 62 patients completed the 6‐ and 12‐month follow‐up assessments. Compared to baseline, there was a 67.5% decrease in adjusted mean NOSE scores at 6 months (mean change −49.6, 95% confidence interval [CI] −54.8 to −44.4; p < 0.001) and a 65.4% decrease at 12 months (mean change −48.1, 95% CI −53.7 to −42.5); p < 0.001), which is consistent with previously published 3‐month results. A 62.0% and 62.5% improvement compared to baseline was observed in the NRS ease‐of‐breathing score at 6 and 12 months, respectively (p < 0.001). No serious adverse were reported overall and no new device‐ or procedure‐related adverse events were reported in the interval between 3 and 12 months posttreatment. Conclusion: TCRF treatment of SSB hypertrophy has a significant and durable effect on improving the symptoms of NAO and health‐related quality of life in patients with symptoms of nasal obstruction and congestion through 12 months postprocedure. [ABSTRACT FROM AUTHOR]

Objective(s): It was the first study to apply and compare two CT methods to assess the validity and clinical significance of structural alterations of the nasal valve in patients with cleft lip nose for assessing nasal ventilation disturbance. Methods: The study collected data from the NOSE score, as well as internal nasal valve area, internal nasal valve angle, external nasal valve area, and septal deviation angle, to evaluate the differences and correlations between those factors in patients with cleft lip and nose. Results: There were significant differences among INV transverse and coronal area and INV angle on different axial standardized planes between clefted side and non-clefted side. There were statistically significant negative correlations between NOSE scores and those indicators of standard plane and acoustic-axis standardized coronal plane. NOSE score and NSD angle were the indicators of significant differences in the measured data of different complications groups (p = 0.002, p = 0.017). The correlation comparison showed that two standardized CT imaging transverse planes have similar correlations in NOSE score, NSD angle, and complications. Conclusion: The results of the two CT evaluation methods showed that there was a significant difference in nasal valve area on the cleft and non-cleft sides, which was significantly associated with nasal ventilation disturbance. The CT evaluation method based on standard axial 3D reconstruction is more convenient to use in the clinic, can be used for pre-surgical evaluation of nasal repair in patients with secondary nasal deformities of unilateral cleft lip, and is valuable for treatment. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to evaluate the effects of nasal septum deviation and inferior turbinate hypertrophy on nasal obstruction by utilizing the Nose Obstruction Symptom Evaluation (NOSE) values and paranasal sinus computed tomography (PSCT) findings for correct preoperative evaluation. Methods Ninety-six patients (57 males and 39 females) aged between 18 and 54 years (mean age, 30.3 ± 9.7 years) participated in this study. Among them, 56 patients underwent septoplasty combined with inferior turbinate outfracture, while 40 patients underwent septoplasty alone. Preoperative nasal examinations were performed on all patients. The direction, location, nasal septum deviation classification, and inferior turbinate hypertrophy size classification were carefully evaluated and compared with the NOSE survey results. PSCT of 56 patients were evaluated and classified by calculating the coronal location of septum deviation, the axial location of septum deviation, the coronal angle of septum deviation, and the axial angle of septum deviation. Results A positive correlation was found between the coronal location of the septal deviation and the preoperative NOSE 2, and the NOSE total, and the difference of postoperative and preoperative NOSE (p = 0.032, p = 0.007, p = 0.021, respectively). There was a statistically significant relationship between the coronal location of the septal deviation classification and the NOSE preoperative total values (p = 0.26). A negative statistically significant correlation was found between inferior turbinate hypertrophy and preoperative NOSE 5 values (p = 0.029). Conclusion We conclude that the combination of PSCT and the NOSE scale is helpful in determining the severity of nasal obstruction prior to surgery. Specifically, we found that nasal septum deviations located in the anterior and coronal planes have a greater impact on nasal obstruction compared to deviations in the axial plane. Inferior turbinate fracture does not provide more benefit than septoplasty alone in treating patients’ nasal obstruction. These findings emphasize the importance of a comprehensive approach in addressing nasal obstruction for optimal patient outcomes.

Background: The aim of this study was to evaluate the effects of nasal septum deviation and inferior turbinate hypertrophy on nasal obstruction by utilizing the Nose Obstruction Symptom Evaluation (NOSE) values and paranasal sinus computed tomography (PSCT) findings for correct preoperative evaluation. Methods: Ninety-six patients (57 males and 39 females) aged between 18 and 54 years (mean age, 30.3 ± 9.7 years) participated in this study. Among them, 56 patients underwent septoplasty combined with inferior turbinate outfracture, while 40 patients underwent septoplasty alone. Preoperative nasal examinations were performed on all patients. The direction, location, nasal septum deviation classification, and inferior turbinate hypertrophy size classification were carefully evaluated and compared with the NOSE survey results. PSCT of 56 patients were evaluated and classified by calculating the coronal location of septum deviation, the axial location of septum deviation, the coronal angle of septum deviation, and the axial angle of septum deviation. Results: A positive correlation was found between the coronal location of the septal deviation and the preoperative NOSE 2, and the NOSE total, and the difference of postoperative and preoperative NOSE (p = 0.032, p = 0.007, p = 0.021, respectively). There was a statistically significant relationship between the coronal location of the septal deviation classification and the NOSE preoperative total values (p = 0.26). A negative statistically significant correlation was found between inferior turbinate hypertrophy and preoperative NOSE 5 values (p = 0.029). Conclusion: We conclude that the combination of PSCT and the NOSE scale is helpful in determining the severity of nasal obstruction prior to surgery. Specifically, we found that nasal septum deviations located in the anterior and coronal planes have a greater impact on nasal obstruction compared to deviations in the axial plane. Inferior turbinate fracture does not provide more benefit than septoplasty alone in treating patients' nasal obstruction. These findings emphasize the importance of a comprehensive approach in addressing nasal obstruction for optimal patient outcomes. [ABSTRACT FROM AUTHOR]

The septal L-strut extension graft (SLEG) consists of anterior extended spreader graft and caudal septal extension graft. SLEG is used to increase the anterocaudal projection from a low-profile nose by creating the de-novo septum. This retrospective study verified the effectiveness of SLEG in improving the nasal function in East Asians. Medical records of patients who underwent septorhinoplasty with SLEG were retrospectively reviewed. The clinical features showed under-projected lower two-thirds of the nose with septal deviation, saddle nose, and short nose. We analyzed the post-operative changes in the NOSE score and variables of nasal geometry measured using acoustic rhinometry through long-term follow-up. Patients were divided into two groups, those who underwent SLEG with turbinoplasty (Group A) and SLEG alone (group B). The NOSE scores decreased significantly in groups A and B, and the improvement was statistically more significant in Group A (p < 0.05). Acoustic rhinometry showed an increase in nasal cavity volume (VOL1) on the deviated side in Group A, and an increase in minimal cross-sectional area 1 (MCA1) on the deviated side in Group B (p < 0.05). The non-deviated side did not show significant reduction in MCA1 and VOL1 after SLEG with or without turbinoplasty. Thus, SLEG, by itself, improved airway function in East Asians. SLEG has proven to be valuable in improving nasal function. [ABSTRACT FROM AUTHOR]

Introduction. Various types of occupational hazards can cause the development of occupational atrophic rhinitis (AR). Researches determine the high prevalence of professional AR among workers in various fields of production. Drug treatment of RA is an important issue. The effectiveness of the use of autologous platelet-enriched plasma is determined. Determining the possibilities of increasing the effectiveness of treatment of professional AR with platelet-enriched plasma is a very relevant issue of modern medicine. The aim. To evaluate the use of autologous platelet-rich plasma in occupational chronic AR compared to standard treatment (irrigation with oil solutions). Materials and methods. 141 patients were examined: I group (32.6%) received irrigation with oil solutions, II (39.7%) – injections of platelet-rich plasma, and III (27.7%) – injections of platelet-rich plasma and irrigation with oil solutions. Results. Significant (p < 0.001) chances of improvement in quality of life levels were found in groups I and II compared to III one month after treatment, based on decreases in the values of the NOSE scale (respectively by 0.946 points and by 5.285 points) and increases values in the SF-36 questionnaire (RE scale and RR by 13.899 points; p = 0.004 and by 15.914 points only with combined treatment; MH scale – by 4.028 points and by 17.880 points; VT scale – by 5.136 points; p = 0.005 and by 24.158 points). Significant (p < 0.001) chances of an increase in nasocytogram indicators were determined in groups I and II compared to III: respectively, the pH of mucus (by 1.029 and by 1.333), the quantitative composition of neutrophils (by 18.958% and by 21.078%) and eosinophils (by 3.540%) combined treatment only) and saccharin test indicators (at 0.3 min; p = 0.005 and at 1.696 min). Conclusions. An improvement in the quality of life and parameters of the nasocytogram and saccharin test was determined when injections of platelet-rich plasma were used (both separately and in combination with irrigation with oil solutions) in patients with occupational chronic AR. Reliable chances of a decrease in NOSE scale values and an increase in SF-36 questionnaire indicators and chances of an increase in nasocytogram and saccharin test indicators were established.

Purpose/Background: Nasal obstruction is a significant issue influencing the patient's quality of life. Chronic nasal obstruction is frequently associated with other symptoms such as headache, sleep disturbance, and daytime sleepiness. This study aims to investigate the prevalence of nasal obstruction in Saudi Arabia and examine its effect on patients' quality of life. Methods: This is a cross-sectional study conducted in Saudi Arabia. Data were collected using a self-administered combination of two previously validated questionnaires (the NOSE scale and the WHOQOL-BREF) translated into Arabic. The Mann–Whitney test was used to investigate the association between nasal obstruction prevalence and the participants' QOL. Results: The study included 1039 participants from different regions of Saudi Arabia. The prevalence of nasal obstruction was 60.3% among the participants. Several factors significantly affected the prevalence of nasal obstruction, including sex, suffering from a chronic disease, having a family member with nasal obstruction, and using medications (P < 0.001 for all factors). A better score was shown in the four domains of the WHOQOL-BREF questionnaire by the participants who had no nasal obstruction: the physical health domain, psychological health, social relationships, and environment (P < 0.001 for all factors). Conclusions: Quality of life is affected by nasal obstruction. The subjective assessment is essential in evaluating the severity of nasal obstruction disease. It is recommended that healthcare providers use subjective tools combined with objective tools to assess the degree of nasal obstruction severity. [ABSTRACT FROM AUTHOR]

Purpose/Background: Nasal obstruction is a significant issue influencing the patient's quality of life. Chronic nasal obstruction is frequently associated with other symptoms such as headache, sleep disturbance, and daytime sleepiness. This study aims to investigate the prevalence of nasal obstruction in Saudi Arabia and examine its effect on patients' quality of life. Methods: This is a cross-sectional study conducted in Saudi Arabia. Data were collected using a self-administered combination of two previously validated questionnaires (the NOSE scale and the WHOQOL-BREF) translated into Arabic. The Mann–Whitney test was used to investigate the association between nasal obstruction prevalence and the participants' QOL. Results: The study included 1039 participants from different regions of Saudi Arabia. The prevalence of nasal obstruction was 60.3% among the participants. Several factors significantly affected the prevalence of nasal obstruction, including sex, suffering from a chronic disease, having a family member with nasal obstruction, and using medications (P < 0.001 for all factors). A better score was shown in the four domains of the WHOQOL-BREF questionnaire by the participants who had no nasal obstruction: the physical health domain, psychological health, social relationships, and environment (P < 0.001 for all factors). Conclusions: Quality of life is affected by nasal obstruction. The subjective assessment is essential in evaluating the severity of nasal obstruction disease. It is recommended that healthcare providers use subjective tools combined with objective tools to assess the degree of nasal obstruction severity.

Abstract Background The objective of this study was to evaluate long‐term symptom improvements in patients with nasal airway obstruction (NAO) secondary to nasal valve collapse (NVC) following minimally invasive temperature‐controlled radiofrequency (TCRF) treatment. Methods A prospective, single‐arm, multicenter study in patients >18 years with NAO due to NVC. Inclusion criteria were response to nasal valve dilation (e.g., modified Cottle maneuver) and baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score ≥60. Patients were treated in the nasal valve region with a TCRF device and followed through 2 years. A responder was ≥20% reduction NOSE Scale score or ≥1 reduction in severity class. Results A total of 122 patients were treated and 91 reached 2 years. The mean baseline NOSE Scale score was 80.3 (95% CI, 78.1–82.6). The adjusted mean change in score at 2 years was −45.8 (95% CI, −53.5 to −38.1), p

Abstract Background Endoscopic septoplasty has become the preferred choice for septal surgeries for most surgeons due to its precise manipulation and reduced wear and tear. However, the improvement of the airway may vary depending upon the type of septal deviation the patient presents with. Cottle in 1946 stated that just mere dealing with deviated septum alone would not ensure a good functional outcome and he further emphasized on addressing portions of the nose obstructing nasal airflow during surgery. The purpose of our study is to subjectively and objectively assess the effectiveness and corrective extent of endoscopic septal correction in different types of septal deviations (Mladina classification) using NOSE scores and Peak Nasal Inspiratory Flowmetry (PNIF). A prospective cross-sectional study was conducted in 87 patients presented in our department from July 2021 to June 2022 for endoscopic septoplasty. Results Post-surgery 1-month follow-up (N1), the correction in terms of NOSE scores was highest in Mladina IV and least in Mladina I deviations, and at the end of 3 months (N2), the correction was best recorded in Mladina VI deviations while the least remained in Mladina I. Similarly, PNIF 1-month follow-up (P1) result had the best correction in the Mladina IV and V groups with the least in Mladina I. 3 months of follow-up (P2) ended up showing a maximum improvement in the Mladina VI group. Paired t test values for improvement of NOSE and PNIF scores were significant (p value

Our study aims to investigate the seasonal effects on the breath and quality of life (QoL) of patients who underwent septorhinoplasty (SRP). A total of 52 patients who underwent SRP between 2018-2023 were included in the study. Two groups those who operated in the winter (winter group, n=26) and those who performed in the summer (summer group, n=26) were evaluated with the NOSE (Nasal Obstruction Symptom Evaluation) scale to reveal the QoL after surgery. Compared with the summer group, NOSE scores in the winter group showed a statistically significant difference (p [Med-Science 2023; 12(4.000): 1210-2]

Background: Nasal airway obstruction (NAO) is a highly prevalent disorder. Septal swell body (SSB) hypertrophy is an often overlooked contributor to NAO. SSB treatment may relieve symptoms of NAO. The objective of this study was to assess the clinical use of a temperature‐controlled radiofrequency (TCRF) device to treat SSBs to improve symptoms in adults with NAO. Methods: In this prospective, multicenter, open‐label, single arm study, patients with severe or extreme NAO related to SSB hypertrophy received bilateral TCRF treatment in the SSB area. The primary endpoint was improvement in Nasal Obstruction Symptom Evaluation (NOSE) Scale scores from baseline to 3 months postprocedure. A subset of study patients underwent computed tomography (CT) imaging to evaluate posttreatment changes in SSB size. Results: Mean NOSE Scale scores significantly improved from 73.5 (SD 14.2) at baseline to 27.9 (SD 17.2) at 3 months postprocedure, a reduction of −45.3 (SD 21.4, 95% confidence interval [CI]: −50.4 to −40.1; p < 0.0001); the responder rate was 95.7% (95% CI: 0.88 to 0.99; p < 0.0001). CT evaluation at 3 months showed statistically significant reductions in the SSB with the greatest reduction in the middle thickness (mean change −3.4 [SD 1.8] mL, 95% CI: −4.0 to −2.8; p < 0.0001). Minimal adverse events with any relationship to the device or procedure were reported; none were serious in nature and no septal perforations occurred. Conclusions: This study demonstrates that TCRF treatment of SSB hypertrophy is well tolerated and effective at reducing both SSB size and symptoms of NAO at 3 months posttreatment. [ABSTRACT FROM AUTHOR]

Background/Aim: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated, reliable, and feasible instrument used to evaluate nasal obstruction severity. We aimed to assess patient satisfaction using the NOSE score after revision rhinoplasty with free diced cartilage (fDC) grafts. Methods: In this cross-sectional study, 36 patients who underwent a revision rhinoplasty procedure completed the Turkish version of the NOSE questionnaire before and six months after rhinoplasty. Pre and postoperative NOSE scores were compared using the Mann Whitney U test. Results: The pre and postoperative total mean NOSE scores were 68.06 and 8.47, respectively. The NOSE score significantly decreased six months after rhinoplasty surgery (P<0.001). Adapting to exercise was the parameter with the highest improvement rate. Conclusion: The outcome of the NOSE questionnaires in patients with nasal deformities shows that a revision rhinoplasty surgery with the placement of fDC grafts contributes to the improvement of nasal functions. The Turkish version of the NOSE scale is a useful tool to assess patient satisfaction among the Turkish population. [ABSTRACT FROM AUTHOR]

Background: Endoscopic septoplasty has become the preferred choice for septal surgeries for most surgeons due to its precise manipulation and reduced wear and tear. However, the improvement of the airway may vary depending upon the type of septal deviation the patient presents with. Cottle in 1946 stated that just mere dealing with deviated septum alone would not ensure a good functional outcome and he further emphasized on addressing portions of the nose obstructing nasal airflow during surgery. The purpose of our study is to subjectively and objectively assess the effectiveness and corrective extent of endoscopic septal correction in different types of septal deviations (Mladina classification) using NOSE scores and Peak Nasal Inspiratory Flowmetry (PNIF). A prospective cross-sectional study was conducted in 87 patients presented in our department from July 2021 to June 2022 for endoscopic septoplasty. Results: Post-surgery 1-month follow-up (N1), the correction in terms of NOSE scores was highest in Mladina IV and least in Mladina I deviations, and at the end of 3 months (N2), the correction was best recorded in Mladina VI deviations while the least remained in Mladina I. Similarly, PNIF 1-month follow-up (P1) result had the best correction in the Mladina IV and V groups with the least in Mladina I. 3 months of follow-up (P2) ended up showing a maximum improvement in the Mladina VI group. Paired t test values for improvement of NOSE and PNIF scores were significant (p value < 0.001) between preoperative, 1-month, and 3-month follow-up values and also for repeated measure ANOVA. Conclusion: Our study reveals that the corrective power of endoscopic septoplasty differs with respect to different types of septal deviation in terms of nasal airflow, both subjectively and objectively. Thus, proper counseling and preoperative assessment is essential for better postoperative outcome and compliance. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate long‐term symptom improvements in patients with nasal airway obstruction (NAO) secondary to nasal valve collapse (NVC) following minimally invasive temperature‐controlled radiofrequency (TCRF) treatment. Methods: A prospective, single‐arm, multicenter study in patients >18 years with NAO due to NVC. Inclusion criteria were response to nasal valve dilation (e.g., modified Cottle maneuver) and baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score ≥60. Patients were treated in the nasal valve region with a TCRF device and followed through 2 years. A responder was ≥20% reduction NOSE Scale score or ≥1 reduction in severity class. Results: A total of 122 patients were treated and 91 reached 2 years. The mean baseline NOSE Scale score was 80.3 (95% CI, 78.1–82.6). The adjusted mean change in score at 2 years was −45.8 (95% CI, −53.5 to −38.1), p < 0.001; a 57.0% improvement. The 2‐year responder rate was 90.1% (95% CI, 82.3%–94.7%). Significant and sustained symptom improvement was achieved in subpopulations based on sex, age, body mass index, baseline NAO severity, nasal surgery history, NVC mechanism, septal deviation, and other anatomic contributors of NAO. No serious adverse events with a relationship to the study device and/or procedure were reported. Conclusions: Minimally invasive TCRF device treatment of the internal nasal valve for NAO is well tolerated and leads to significant and sustained improvement in NAO symptom severity through 2 years, including in patients with both static and dynamic NVC, septal deviation, turbinate enlargement, or prior nasal surgery. Level of Evidence: 2b. [ABSTRACT FROM AUTHOR]

Abstract 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 Cronbach's α 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

Abstract Objective Nasal obstruction is a common complaint. The Nasal Obstruction Symptom Evaluation scale (NOSE) is a reliable validated tool used to assess the quality of life of patients with nasal obstruction. The purpose of this study is to validate the Hebrew version of the NOSE scale (He‐NOSE). Methods A prospective instrument validation was conducted. The NOSE scale was translated primarily from English to Hebrew and then back from Hebrew to English according to the accepted guidelines of the cross‐cultural adaptation process. The study group included surgery candidates suffering from nasal obstruction due to a deviated nasal septum and/or inferior turbinate hypertrophy. The study group completed the validated He‐NOSE questionnaire twice prior to the surgery and once again, a month post‐surgery. A control group of individuals with no history of nasal complaints or surgeries was asked to complete the questionnaire once. Reliability, internal consistency, validity, and responsiveness to change of the He‐NOSE were evaluated. Results Fifty‐three patients and 100 controls were included in this study. The scale showed excellent ability to discriminate between the study and the control group, exhibiting significantly lower scores in the control group (73.8 and 7 average scores respectively, p

Our study aims to investigate the seasonal effects on the breath and quality of life (QoL) of patients who underwent septorhinoplasty (SRP). A total of 52 patients who underwent SRP between 2018-2023 were included in the study. Two groups those who operated in the winter (winter group, n=26) and those who performed in the summer (summer group, n=26) were evaluated with the NOSE (Nasal Obstruction Symptom Evaluation) scale to reveal the QoL after surgery. Compared with the summer group, NOSE scores in the winter group showed a statistically significant difference (p<0.05). Septorhinoplasty is a surgical procedure expected to increase the QoL of patients regardless of the season and climate. The low mean NOSE score observed in the winter showed that the postoperative patient comfort was significantly higher compared who underwent surgery in the summer. Therefore, encouraging patients to undergo surgery intensively during the winter months in SRP will be positive for postoperative QoL. Future studies may reveal more illuminating results for increasing patient comfort by considering different surgical techniques, climates, and months. [ABSTRACT FROM AUTHOR]

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.

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 Cronbach's α 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. Level of Evidence: NA. A validation study of the Swedish version (S‐NOSE) of the Nasal Obstruction Symptom Evaluation scale. The study shows that the S‐NOSE is reliable, valid, responsive, and psychometrically sound. The S‐NOSE can be recommended in both clinical practice and research to evaluate the outcome of septoplasty in Swedish‐speaking populations. [ABSTRACT FROM AUTHOR]

Background: Deviated Nasal Septum with Hypertrophy of Inferior turbinate on opposite side is a common finding. There are various objective and subjective tests to assess nasal obstruction. Materials and Methods: In this Randomized Controlled trail 82 subjects of Deviated Nasal Septum and contralateral hypertrophy of Inferior Turbinate were included. Subjects were randomly divided into two surgical groups, Septoplasty with inferior turbinoplasty and septoplasty alone. Pre and postoperative Subjective assessment of nasal obstruction was done with NOSE scale and Objective assessment by Nasal endoscopy. Results: Post operative improvement in nasal symptoms on NOSE scale was from 15.83± 1.99 to 7.63 ± 1.34 in septoplasty with turbinoplasty group and that in septoplasty alone group it improved from 15.15 ± 2.14 to 10.05 ± 1.79 which was statistically significant improvement in both the groups. But on comparison amongst to groups postoperative improvement in nasal symptoms was more significant statistically in Septoplasty with inferior turbinoplasty group (p<0.001). Conclusion: In patients with symptomatic nasal septal deviation with hypertrophy of the contralateral inferior turbinate, septoplasty along with inferior turbinoplasty provides better symptomatic relief of nasal symptoms than septoplasty alone. [ABSTRACT FROM AUTHOR]

Objective: Nasal obstruction is a common complaint. The Nasal Obstruction Symptom Evaluation scale (NOSE) is a reliable validated tool used to assess the quality of life of patients with nasal obstruction. The purpose of this study is to validate the Hebrew version of the NOSE scale (He‐NOSE). Methods: A prospective instrument validation was conducted. The NOSE scale was translated primarily from English to Hebrew and then back from Hebrew to English according to the accepted guidelines of the cross‐cultural adaptation process. The study group included surgery candidates suffering from nasal obstruction due to a deviated nasal septum and/or inferior turbinate hypertrophy. The study group completed the validated He‐NOSE questionnaire twice prior to the surgery and once again, a month post‐surgery. A control group of individuals with no history of nasal complaints or surgeries was asked to complete the questionnaire once. Reliability, internal consistency, validity, and responsiveness to change of the He‐NOSE were evaluated. Results: Fifty‐three patients and 100 controls were included in this study. The scale showed excellent ability to discriminate between the study and the control group, exhibiting significantly lower scores in the control group (73.8 and 7 average scores respectively, p <.001). Good internal consistency (Cronbach's alpha.71 and.76) and test–retest reliability (Spearman rank correlation r =.752, p <.0001) were measured. Moreover, the scale revealed remarkable responsiveness to change (p <.00001). Conclusion: The translated and adapted He‐NOSE scale can be a useful tool to be applied in both clinical and research fields when assessing nasal obstruction. Level of evidence: N/A. [ABSTRACT FROM AUTHOR]

The effects of different climatic conditions on the quality of life (QoL) of patients following septoplasty or septorhinoplasty were investigated. A total of 89 patients (47 males and 42 females) underwent either septoplasty or septorhinoplasty during the summer (summer group, n = 42) or winter (winter group, n = 47) season. To assess QoL, SinoNasal Outcome Test (SNOT)-22, Nasal Obstruction Symptom Evaluation (NOSE) scale, and Visual Analogue Scale were used. Postoperative (PO) pain, bleeding, and symptoms related to nasal packing (eating and sleep problems) were also evaluated. PO pain scores were lower in the winter group than that in the summer group (p <0.05). After pack removal, there was a slight serohemorrhagic nasal discharge in 2.1% of the patients in the winter group, but no patient required intervention. Slight leakage was detected in 47.6% of the patients and 2.4% of the patients called for intervention (p <0.05) in the summer group. The SNOT-22 values did not differ between the groups (p >0.05). NOSE scores in the winter group were higher than that in the summer group (p <0.05). In each group, SNOT-22 (p adjusted <0.175) and NOSE scores (p <0.05) were lower at 1 month after surgery. The winter group patients rated headache, facial pain, and nasal crusting higher than those in the summer group did (p <0.05). However, nasal discharge and loss of smell were less troubling in the summer group than that in the winter group (p <0.05). Regardless of climate or season, septoplasty or septorhinoplasty increases patients' QoL. However, problematic PO bleeding was detected at a higher frequency in patients who underwent surgery in summer. The advantage of surgery in winter is that it leads to less frequent problematic bleeding PO. [ABSTRACT FROM AUTHOR]

Objective: To determine the independent role of nasal obstruction on blood pressure (BP) control in patients with hypertension comorbid obstructive sleep apnea (OSA). Subjects and methods: This cross-sectional study comprised of 326 newly diagnosed OSA comorbid hypertension patients from March 2018 to December 2021. Sixty-six patients have controlled hypertension, two hundred and nine with uncontrolled hypertension and fifty-one with resistant hypertension. Information on demographic characteristics, sleep data, hypertension status was collected. Multivariate logistic regression models were used to determine the odds ratios (OR). Results: Patients with nocturnal nasal congestion had more difficult to control blood pressure, with more numbers of antihypertensive drugs. They tended to have more severe OSA, lower nocturnal oxygen saturation and more severe sleepiness. Univariate analysis showed that nocturnal nasal congestion and Nasal Obstruction Symptom Evaluation (NOSE) Scale scores were associated with uncontrolled BP. After adjusting for age, sex, smoking, alcohol use, OSA severity and CT90, multivariate logistic analysis models showed that nocturnal nasal congestion was independently associated with uncontrolled hypertension (OR = 2.09, p = 0.023). When analyzed more severe resistant hypertension, nocturnal nasal congestion showed a higher association (OR = 2.96, p = 0.014). Conclusion: This cross-sectional study demonstrated that the nocturnal nasal congestion was independently associated with uncontrolled BP. The use of nasal decongestants or nasal surgery may be a potential therapeutic target for resistant hypertension in the future. [ABSTRACT FROM AUTHOR]

Objective: Nasal septum perforation (NSP) is defined as a communication between the nasal passages due to a full layer defect of the septum. The condition has a broad spectrum of potential symptoms, such as scabbing inside the nose, dryness, epistaxis, and breathing difficulty. The aim of this study was to evaluate the symptomatology of NSP and the relationship between the subcomponents of the Nasal Obstruction Symptom Evaluation (NOSE) scale assessment of quality of life and the size and localization of NSP. Materials and Methods: This prospective study included patients who presented at the otolaryngology policlinics of 2 hospitals and were diagnosed with NSP. The NSPs were grouped according to the length of the long axis, that is, small: 1--10 mm, medium: 11--20 mm, or large: 21--30 mm, and the localization was categorized as anterior, middle, or posterior. A Turkish version of the NOSE scale has been validated as a reliable tool. Results: A total of 61 patients, 31 (50.8%) females and 30 (49.2%) males, were evaluated. The mean NOSE score was 59.50±20.58. No significant difference was seen in the NOSE score based on the size of the perforation; however analysis of variance revealed a significant difference according to the localization of the perforation in the scale items of NOSE-2 (p=0.007), NOSE-3 (p=0.048), NOSE-4 (p=0.011), and the total NOSE score (p=0.015) (p<0.05). Conclusion: The results of the NOSE scale analysis indicated that the NSP patients experienced a high level of symptoms, regardless the size and localization of the perforation. The NOSE scale is easy to administer and provides useful information, particularly when the subcomponents are evaluated. [ABSTRACT FROM AUTHOR]

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 endpoints, 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.

Abstract Background The Nasal Obstruction Symptom Evaluation (NOSE) scale has been developed and validated in English to overcome the controversies concerning other methods of evaluation of nasal obstruction. The scale is currently used worldwide and has been translated into several languages. The purpose of the present work was to translate the English (NOSE) scale into Arabic (A-NOSE) and to assess its validity and reliability in Arabic-speaking patients. Results The internal consistency and test-to-test reliability of the Arabic scale were statistically good. The differences between the scores of the patients and control subjects were statistically significant. Postoperative scores of the patients were significantly higher than preoperative scores. All participants completed the Arabic questionnaire easily and few of them required slight assistance. Conclusions The translated NOSE scale is easy to administer and can be a robust and usable outcome measure for patients with nasal obstruction. The translated scale is sensitive to changes in nasal airway patency and can be used in clinical practice and outcome research.

Abstract 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

Background: Nasal valve collapse is one of several causes of nasal obstruction. The safety and efficacy of a temperature‐controlled radiofrequency (RF) device for the treatment of the nasal valve for nasal airway obstruction (NAO) has been established in single‐arm studies. The objective of this trial was to compare active device treatment against a sham procedure (control). Methods: In a prospective, multicenter, single‐blinded, randomized controlled trial (RCT), patients were assigned to bilateral temperature‐controlled RF treatment of the nasal valve (n = 77) or a sham procedure (n = 41), in which no RF energy was transferred to the device/treatment area. The device was applied to the mucosa over the lower lateral cartilage on the lateral nasal wall. The primary endpoint was responder rate at 3 months, defined as a ≥20% reduction in Nasal Obstruction Symptom Evaluation (NOSE)‐scale score or ≥1 reduction in clinical severity category. Results: At baseline, patients had a mean NOSE‐scale score of 76.7 (95% confidence interval [CI], 73.8 to 79.5) and 78.8 (95% CI, 74.2 to 83.3) (p = 0.424) in the active treatment and sham‐control arms, respectively. At 3 months, the responder rate was significantly higher in the active treatment arm (88.3% [95% CI, 79.2%‐93.7%] vs 42.5% [95% CI, 28.5%‐57.8%]; p < 0.001). The active treatment arm had a significantly greater decrease in NOSE‐scale score (mean, −42.3 [95% CI, −47.6 to −37.1] vs −16.8 [95% CI, −26.3 to −7.2]; p < 0.001). Three adverse events at least possibly related to the device and/or procedure were reported, and all resolved. Conclusion: This RCT shows temperature‐controlled RF treatment of the nasal valve is safe and effective in reducing symptoms of NAO in short‐term follow‐up. [ABSTRACT FROM AUTHOR]

Objective/Hypothesis: The Nasal Obstruction Symptom Evaluation (NOSE) is a disease specific quality of life instrument developed and validated in adults. The objective of this study is to evaluate the validity of the NOSE scale for pediatric nasal obstruction. We also examined the effect of septoplasty with bilateral inferior turbinate reduction in this population. Study Design: A validation study at a tertiary care children's hospital. Methods: Thirty‐eight pediatric patients who underwent septoplasty and bilateral inferior turbinate reduction between 2014 and 2018 were included. Patients were administered the NOSE instrument on the day of their clinic evaluation, the day of surgery, and at their 6 to 8‐week post‐operative appointment. A sample of 40 pediatric patients with non‐rhinologic complaints was also included. Confirmatory factor analysis was performed to evaluate the factorial validity of the NOSE instrument. Results: Of the 78 patients included, the mean age was 15.4 years (SD 3.4). In the confirmatory factor analysis, factor loadings were all significant and ranged from 0.95 to 0.99. Internal consistency reliability using Omega and maximal reliability H indices were well above recommended standards (Omega = 0.983 and maximal H = 0.988). Test–retest reliability was also adequate. Mean NOSE scores significantly improved following surgery (from 96.7 [SD 6.2] to 8.8 [SD 7.8]; mean difference = −87.9; 95% CI: −84.5, −91.3; P <.001). Similar improvements were observed across age groups. Conclusions: The NOSE scale is a valid and reliable quality of life instrument for pediatric patients with nasal obstruction. Nasal septoplasty with bilateral turbinate reduction substantially improved symptoms of nasal obstruction. Level of Evidence: 4 Laryngoscope, 131:E2594–E2598, 2021 [ABSTRACT FROM AUTHOR]

Objectives: Chronic rhinosinusitis (CRS) is a common chronic respiratory disorder. This study aimed to investigate the relation between nasal obstruction and sexual dysfunction in men with CRS. Methods: In this case-control study, 100 married men aged 19 to 48 years with CRS and 56 healthy married men were selected, consecutively. For assessment of nasal obstruction severity NOSE scale (Nasal Obstruction Symptom Evaluation) was used and IIEF (International Index of Erectile Function) inventory was used to assess sexual function. Results: Mean age of patients with CRS and controls was 33.25 ± 6.5 and 30.58 ± 7.12 years, respectively. Nasal obstruction was moderate in 70% of patients and 95% of patients had some degrees of erectile dysfunction. A significant association was found between nasal obstruction severity and sexual function and by increasing severity of nasal obstruction, sexual function decreased significantly in CRS patients. Sexual function in total (IIEF score) and in its domains, except for sexual desire, were significantly higher in control group (P <.05). Conclusion: There is significant inverse association between severity of nasal obstruction and sexual function. Sexual function decreases with increasing severity of nasal obstruction in CRS. CRS patients also have lower sexual function scores than healthy control males. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate validity and reliability of Lithuanian version of Nasal Obstruction Symptom Evaluation Scale (L-NOSE), designed for the assessment of nasal obstruction. Methods: 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. Results: 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 < 0.01) scores. In patients' group, positive moderate correlations between L-NOSE scores and Sino-nasal Outcome Test-22 logically similar domain scores were found, thus indicating good convergent construct validity. L-NOSE scores for control subjects were generally lower than for patients with nasal obstruction (p < 0.001), thereby indicating good discriminant validity of questionnaire. The exploratory factor analysis confirmed one-factor structure of questionnaire. The component matrix of L-NOSE ranged from 0.667 to 0.781 (KMO = 0.754, p < 0.0001). The mean L-NOSE score improved from 58.4 ± 18.2 points to 11.1 ± 9.5 points after septoplasty (p < 0.0001), indicating good responsiveness of questionnaire. Conclusion: The L-NOSE questionnaire is a valid instrument with satisfactory reliability, validity, and responsiveness. [ABSTRACT FROM AUTHOR]

Background: To evaluate the impact of endoscopic sinus surgery (ESS) on clinical outcomes, quality of life (QoL) and Nasal Obstruction and Symptom Evaluation (NOSE) scale in patients with CRSwNP and CRSsNP. An additional question that needs to be investigated is whether there is a correlation between patients at the age of relapse. Methodology/principal: A prospective cohort study of 150 subjects [96 males, 54 females, mean age: 51.99 ± (15.73)]. The SNOT-22 and NOSE questionnaires were used to measure the patients' QoL and their nasal blockage symptoms, respectively. Endoscopic and computerized tomography (CT) scores depicted the objective findings. Results: Following ESS, the endoscopic scale showed a significant improvement in 83.85% of patients. QoL measured with SNOT-22 improved by 78.85% and with NOSE scale by 92.10%. Also, a statistically significant correlation was found between NOSE, SNOT-22 and the Lund–Kennedy scale. Recurrence was observed in 13 patients during follow-up. There was no statistically significant correlation between age, gender, smoking and recurrence tendency. Patients with baseline SNOT-22 and NOSE scores lower than 30 typically fail to obtain a clinically meaningful benefit. Patients with a rate greater than or equal to 40 achieved a minimal clinically important difference (MCID) of 83.9% and had an average symptom reduction (RI) rate of 60.3%. Conclusions: ESS is an important treatment option for symptomatic patients with CRSwNP and CRSsNP. Both objective and subjective measurements including QoL improved significantly, and the results stabilized at 12 to 18 months. The NOSE scale is a sensitive outcome measure in the CRS population, including subjects with and without nasal polyps. In our study, SNOT-22 and NOSE are excellent predictors of postoperative improvement. [ABSTRACT FROM AUTHOR]

Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified. [ABSTRACT FROM AUTHOR]

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 ∆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. [ABSTRACT FROM AUTHOR]

The objective of this paper is to investigate the differences between unilateral and bilateral nasal obstruction with subjective symptomatology in nasal obstruction. This is a retrospective chart review of prospectively collected data of patients with nasal obstruction presenting to a facial plastic and reconstructive surgery clinic for evaluation and treatment. Patient demographics including age and gender were recorded along with nasal physical exam findings. These included internal valve narrowing (IVN), external valve narrowing, internal valve collapse, external valve collapse, and septal deviations (inferior and superior). Findings were reported for the left, the right, and both sides. Nasal valve and septal findings were recorded on 3- and 4-point Likert scales, respectively, for each side of the nose. A total of 1,646 patients were included in the study. On univariate analysis, a significant correlation was seen between Nasal Obstruction Symptom Evaluation (NOSE) scores and all individual exam findings ( p  < 0.001). On multiple linear regression, total, left, and right septal deviation ( p  < 0.001, p  = 0.001, p  = 0.007, respectively) and total, left, and right IVN ( p  < 0.001, p  = 0.003, p  < 0.001) were all predictive of an increased NOSE score. Patients with unilateral septal deviation or internal nasal valve narrowing have symptoms of nasal obstruction similar to those with bilateral nasal obstruction. Unilateral and bilateral septal deviation and internal nasal valve narrowing are predictive of having an increased NOSE score. Unilateral nasal obstruction should be recognized and treated as a cause for severe symptomatic nasal obstruction despite a normal contralateral nasal exam. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the psychometric properties of the nasal obstruction symptom scale within a sample of pediatric patients undergoing septoplasty or functional septorhinoplasty.Study Design: This was a prospective study with nasal obstruction symptom scale evaluations conducted pre- and postoperatively.Setting: A tertiary care pediatric hospital.Subjects and Methods: Pediatric patients underwent septoplasty or functional septorhinoplasty (FSR) from January 2013 to January 2017. Reliability of the scale was assessed through measures of internal consistency. In addition, item response models of each item were evaluated to assess how well each item captured individuals with varying levels of nasal obstruction. Study authors assessed face validity, and construct validity was assessed by correlation measures between items and exploratory factor analysis.Results: A total of 136 patients, ages 8 to 18 years with a mean age of 15.7 ± 2.1 years, completed pre- and postoperative evaluations. Internal consistency of the scale was high (Cronbach's α = 0.83). Predominantly a unidimensional scale resulted from exploratory factor analyses. Item response models indicate questions capture low to moderate levels of nasal obstruction within this population. Additional analyses show the scale functions similarly between septoplasty and FSR patients.Conclusion: The Nasal Obstruction Symptom Evaluation scale is a robust tool that may be incorporated as a subjective evaluation of severity of nasal obstruction among pediatric patients undergoing a septoplasty or functional septorhinoplasty. [ABSTRACT FROM AUTHOR]

Purpose: 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). Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

En Abstract Context Nasal obstruction is a very common complaint, which may be caused by various causes, one of the most important being septal deviation. Many techniques have been described to correct these septal deviations since the middle of 19th century. There have been several modifications since its inception. The application of endoscopic techniques to correct septal deformities was initially described by both Lanza and colleagues and by Stammberger in 1991. Aims Comparing the efficacy of endoscopic septoplasty with traditional septoplasty in the treatment of cases with septal deviations. Patients and methods Thirty cases complaining mainly of nasal obstruction due to significant septal deviations were selected. They were randomly divided into two groups: group A patients underwent endoscopic septoplasty and group B underwent traditional septoplasty. The Nasal Obstruction Symptom Evaluation (NOSE) scale was an important step in assessment. Results The two procedures are suitable to correct septal deformities, with a slight upper hand for the endoscope in particular cases. We highlight in this study the advantages and disadvantages of the use of the nasal endoscope to correct nasal septal deviation. Conclusion Although mainly used in sinus surgery, the endoscope has also found its way in nasal septal surgery as it facilitates accurate identification of the pathology due to better illumination, improved accessibility to remote areas and magnification. It allows precise resection of the pathological areas without the need of an extended dissection. Endoscopic septoplasty is associated with a significant reduction in the patient’s morbidity in the postoperative period due to limited extent of flap dissection and limited manipulation and resection of the septal framework. However, the endoscope has its own limitations which include loss of binocular vision and the need for frequent cleaning. The NOSE scale also correlates well with the postoperative results of the study.

Objective This study assessed disease-specific quality-of-life outcomes among pediatric patients undergoing septoplasty or functional septorhinoplasty. The Nasal Obstruction Symptom Evaluation (NOSE) score was obtained pre- and post-operatively. Additional analyses determined whether demographics, nasal trauma, prior nasal surgery, or allergic rhinitis history affected NOSE scores. Methods Patients undergoing septoplasty or functional septorhinoplasty were evaluated prospectively at a tertiary children's hospital. NOSE scores were assessed pre- and post-operatively. Change in NOSE score was analyzed using the Wilcoxon Signed Rank test, while multiple regression analysis evaluated factors associated with NOSE score change. Results 136 patients (mean age 15.7 ± 2.1 years) were evaluated; 52 (38.2%) underwent septoplasty while 84 (61.8%) underwent functional septorhinoplasty. Mean follow-up was 3.6 ± 5.1 months. There was a statistically significant decrease in NOSE score from pre-operative septoplasty and functional septorhinoplasty: median = 75 to post-operative septoplasty: median = 20 (z = −5.9, p < 0.001) and functional septorhinoplasty: median = 15 (z = −7.9, p < 0.001). Gender, age, nasal trauma, prior nasal surgery, and allergic rhinitis did not have a significant effect on NOSE score change for either group. Additional surgery at the time of procedure was not a confounding variable in the relationship between surgery type and NOSE score. A NOSE Scale reliability analysis demonstrated high internal consistency with Cronbach's α of 0.83 across septoplasty and functional septorhinoplasty patients. Conclusion There was significant improvement in disease-specific quality-of-life in pediatric patients undergoing septoplasty or functional septorhinoplasty. Gender, nasal trauma, prior nasal surgery, and allergic rhinitis did not significantly affect NOSE scores in either group. [ABSTRACT FROM AUTHOR]

Background Nasal symptoms are a major problem affecting the quality of life of lowlanders deployed at high altitude. Study was carried out in fresh male inductees inducted in high altitude of 11,500 ft (3500 m) above sea level to evaluate the nasal obstruction using the subjective Nasal obstruction and symptom evaluation (NOSE) score and rhinomanometry during the stay in high altitude. Methods A prospective study was carried out in 100 males inducted into high altitude. The subjects were evaluated using the subjective assessment tool, NOSE scale and rhinomanometry on induction and after 2 months. The data were analysed for NOSE scale in the 1st and 2nd visit by test for equality of proportions and the total nasal airway resistance (Pa) has been expressed as mean ± standard deviation and compared across severity of NOSE score using one way ANOVA and between 1st and 2nd visit using paired t test. Results and conclusions Out of the 100 subjects, 77 came for the 2nd review after 2 months. There was statistically significant worsening in the subjective feeling of nasal obstruction during the stay in high altitude without any significant change in the nasal airway resistance. [ABSTRACT FROM AUTHOR]

The nasal obstruction symptom evaluation (NOSE) scale is a validated disease-specific, self-completed questionnaire for the assessment of quality of life related to nasal obstruction. The aim of this study was to validate the Dutch (NL-NOSE) questionnaire. A prospective instrument validation study was performed in a tertiary academic referral center. Guidelines for the cross-cultural adaptation process from the original English language scale into a Dutch language version were followed. Patients undergoing functional septoplasty or septorhinoplasty and asymptomatic controls completed the questionnaire both before and 3 months after surgery to test reliability and validity. Additionally, we explored the possibility to reduce the NOSE scale even further using graded response models. 129 patients and 50 controls were included. Internal consistency (Cronbach's alpha 0.82) and test-retest reliability (intraclass correlation coefficient 0.89) were good. The instrument showed excellent between-group discrimination (Mann-Whitney U = 85, p < 0.001) and high response sensitivity to change (Wilcoxon rank p < 0.001). The NL-NOSE correlated well with the score on a visual analog scale measuring the subjective sensation of nasal obstruction, with exception of item 4 (trouble sleeping). Item 4 provided the least information to the total scale and item 3 (trouble breathing through nose) the most, particularly in the postoperative group. The Dutch version of the NOSE (NL-NOSE) demonstrated satisfactory reliability and validity. We recommend the use of the NL-NOSE as a validated instrument to measure subjective severity of nasal obstruction in Dutch adult patients. [ABSTRACT FROM AUTHOR]

The literature still lacks a review regarding PROs applied for rhinoplasty. Thus, we performed a systematic review of the literature to identify PROMs that assess patient satisfaction and quality of life after rhinoplasty. The aim of our study was to identify existing questionnaires and to summarize their development, psychometric properties, and content. A multi-step search of the web-based PubMed database from the National Library of Medicine was performed to identify PROMs that are designed to evaluate satisfaction and quality of life following rhinoplasty. Each potential PROM was examined by three independent reviewers for adherence to inclusion/exclusion criteria. Questionnaires included in the analysis were appraised for their adherence to international guidelines for the development and validation of health outcome questionnaires, as outlined by the Scientific Advisory Committee of the Medical Outcome Trust and the U.S. Food and Drug Administration. Our search generated a total of 457 articles, 351 that were retrieved in the primary search, and 106 that were found in the references of the first set of articles. The process of development and validation of each of the included PROMs was examined. Only ten of these were identified as surgery-specific questionnaires about rhinoplasty. These were divided into three categories: (1) functional self-assessment (Nasal Surgical Questionnaire, Nasal Obstruction Symptoms Evaluation Scale, and Nasal Obstruction Septoplasty Effectiveness); (2) aesthetic self-assessment (Utrecht Questionnaire, FACE-Q rhinoplasty module, Glasgow Benefit Inventory); and (3) aesthetic and functional self-assessment (Rhinoplasty Outcomes Evaluation), Functional Rhinoplasty Outcome Inventory 17, RHINO Scale, and Evaluation of Aesthetic Rhinoplasty Scale). [ABSTRACT FROM AUTHOR]

Objective: The Nasal Obstruction Symptom Evaluation (NOSE) scale has been used to demonstrate that surgery improves nasal obstruction, but no study has directly compared surgical techniques. We performed a retrospective study comparing NOSE scores to quantify the effects of spreader grafting on postoperative nasal patency. Methods: We compared NOSE scores of patients who underwent septoturbinoplasty to open septorhinoplasty with spreader graft placement. We used a paired samples t test to evaluate the difference between pre- and postoperative NOSE scores and the improvement in NOSE score between patients who underwent septoturbinoplasty and those who underwent open septorhinoplasty with spreader graft placement. Results: Surgery reduced NOSE scores by an average of 46 points (P < .001). The mean differences in NOSE score across all time points after septoturbinoplasty and septorhinoplasty with spreader graft placement was 40 and 49, respectively. The mean improvement in NOSE score at the second follow-up appointment was 27 for patients who had undergone septoturbinoplasty and 51 for patients who had undergone septorhinoplasty with spreader graft placement (P = .04). Conclusion: This is the largest study quantifying the effect of spreader grafting. Greater improvement was observed from septorhinoplasty with spreader graft placement than septoturbinoplasty, and this improvement persisted over time. [ABSTRACT FROM AUTHOR]

Objective: Determine the prevalence of nasal airway obstruction (NAO) in patients presenting to general otolaryngology clinics using the Nasal Obstruction Symptom Evaluation Scale (NOSE) score as a screening tool. Study Design: The clinic staff at 149 otolaryngology specialty clinics geographically distributed in the United States administered the NOSE Scale assessment to 3533 patients presenting to the clinics over a period of 1 week, regardless of the reason for the visit. All patients completed the NOSE Scale score, and additional data were collected, including the primary reason for the visit. Demographic and patient characteristics were summarized using frequencies and percentages for categorical variables. Results: The overall mean NOSE Scale score for the 3533 patients surveyed was 37.6 (SD 31.5). A total of 37.4% (1320/3533) of surveyed patients, regardless of visit reason, had severe/extreme NAO symptoms. Overall, the most common visit reason category was "Other" (61.2%, 2162/3533), followed by "NAO" (22.6%, 798/3533) and "Sinus" (16.2%, 573/3533). The mean NOSE scores for patients in each of the visit categories were 23.4 (SD 25.9), 64.7 (SD 23.3), and 53.3 (SD 28.1); for "Other," "NAO," and "Sinus," respectively. Among the patients coming in with "NAO" or "Sinus" as a primary complaint, 76.2% (608/798) and 57.2.% (328/573) had severe or extreme NOSE scores. A total of 17.8% (384/2162) of patients coming in for "Other" reasons had NOSE scores indicating severe/extreme NAO symptoms. Conclusions: The findings of this large, descriptive otolaryngology practice survey found a high prevalence of moderate to severe/extreme NAO among patients presenting to otolaryngology practices. Incorporating assessments, such as the NOSE Scale score and other diagnostic practices into the patient intake workflow and assessments, could help identify symptomatic NAO patients that might otherwise be overlooked., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Raithatha is a consultant for Aerin Medical.Dr. Del Signore has no declarations of conflicting interests.

Objective:To measure the effect of localization of septal deviation on the success of septoplasty using the-Nose Obstruction Symptom Evaluation (NOSE) scale in patients undergoing septoplasty and endoscopic reduction of inferior turbinates.Methods:Patients who attended Oltu Goverment Hospital ENT clinic with nasal septal deviation between March 2011 and June 2012 were included in this study. Patients who had paranasal sinus problems other than concha hypertrophy and revision cases were excluded from this study. Septal deviation was classified according to the position of the internal nasal valve as anterior, posterior or anteroposterior. All patients were examined with nasal endoscopy before and after operation and received a preoperative paranasal tomography scan. The effect of septal deviation on quality of life was evaluated using the NOSE scale preoperatively and 6 months postoperatively. All patients had endoscopic septoplasty and inferior concha reduction under general anaesthesia.Results:Ninety-seven (40 female, 57 male) patients underwent endoscopic septoplasty and concha reduction between 2011 and 2012 in Oltu Government hospital. The mean age was 29.8 years. Anterior deviation was 45, posterior deviation was 33, and anteroposterior deviation was 19. Patients with anterior deviation had a mean NOSE scale of 78.2 preoperatively and 5.8 postoperatively. Patients with posterior deviation had a mean NOSE scale of 79.2 preoperatively and 15.4 postoperatively. Patients with anteroposterior deviation had a mean NOSE scale of 82.4 preoperatively and 22.5 postoperatively (p