Details
Category: Volume 08 Issue 01 January 2020
Hits: 1202

Title: A Study to Assess the Improvement in Pulmonary Function Tests after Septoplasty or Submucosal Resection of Nasal Septum

Authors: Apurva Anil Jarandikar, Jagannatha B., Huliraj N.

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.72

Abstract

Deviated nasal septum (DNS) is the most common cause of nasal obstruction. A narrow nasal airway would result in a decreased airflow in the lungs. Surgical correction of deviated nasal septum by septoplasty or submucosal resection results in alterations in the upper and lower airway resistance and improves nasal symptoms and general quality of life (QOL). The improvement in pulmonary function tests can be assessed with the help of this study. After obtaining the ethical committee clearance, 60 patients who meet the inclusion criteria were enrolled in the study and were asked to undergo pulmonary function test (PFT) like spirometry and 6 minutes’ walk test (6MWT) and fill the SNOT22 questionnaire before surgery. Septoplasty or SMR was performed. Patients were followed up after 1 month and 6 months after surgery and spirometry, 6MWT were done at that time. SNOT22 questionnaire was filled. Different parameters of spirometry, 6MWD and SNOT-22 scores before and after surgery were analysed. The mean age of the patients was 31.5 years.63.3% patients were males and 36.7% were females. 65% had DNS to left, while 30% had DNS to right side.5% had S shaped DNS. The mean difference in post-op and pre-op values was statistically significant for FEV1, FVC, FEV1/FVC RATIO, FEF25-75% (P-value < 0.001).  The overall mean percentage SNOT-22 Score was decreased by 57.2. The overall 6MWD was increased by 6.80% after 6 months. Considerable improvement was seen in the symptoms, QOL and exercise capacity.

Keywords: nasal septum, septoplasty, spirometry, quality of life.

References

  1. Mohan Bansal. Diseases of Ear, Nose and Throat with Head & Neck Surgery.2nd Edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.;2018.p.30-362.
  2. Hirbod B, Sadra K, Ehsan J, Yekta P, Soheila Y.D., Farshid N F et.al.Nasal septum surgery: evaluation of pre and post-operative respiratory function in patients with septal deviation by acoustic rhinometry and rhinomanometry. Bulletin of Environment, Pharmacology and Life Sciences.2014 March;3(5):181-83Available from URL-http://www.bepls.com
  3. H.S.Satish, Dr. K.T. Sreedhar. Septoplasty outcome using Snot-22 questionnaire study. IOSR-Journal of Dental and Medical Sciences (IOSR-JDMS).e-ISSN:2279-0853, p-ISSN:2279-0861.2013 May-June;6 (5):34-38
  4. Bulcun E, Kazkayasi M, Ekici MA, Tahran FD, Ekici M. Effects of septoplasty on pulmonary function tests in patients with nasal septal deviation. J Otolaryngol Head Neck Surg. 2010 Apr;39(2):196-202.
  5. Tuzuner A, Bilgin G, Demirci S, Darilmaz G, Acikgoz C, Samim E. Improvement of pulmonary functions following septoplasty: how are lower airways affected? Clinical and Experimental Otorhinolaryngology.2016 March; 9(1):51-55. Available from URL-http://dx.doi.org/10.21053/ceo.2016.9.1.51
  6. Buckland JR, Thomas S, Harries PG. Can the Sinonasal outcome test(SNOT-22)be used as a reliable outcome measure for successful septal surgery? Clinical Otolaryngology & Allied Sciences.2003 Feb 1; 28(1):43-7.
  7. Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test.Clinical Otolaryngology.2009 Oct 1; 34(5):447-54.
  8. Gandomi B, BayatA, Kazemei T. Outcomes of septoplasty in young adults:the Nasal Obstruction Septoplasty Effectiveness study. American Journal of Otolaryngology.2010 Jun 30;31(3):189-92.
  9. Ahmed R, Nicolas Y, Michael J, David A. Clinical assessment is an accurate predictor of which patients will need septoplasty. The Laryngoscope 2013;123(1):48-52.
  10. Panicker VB, Belaldavar BP. Effectiveness of septoplasty on pulmonary function tests in symptomatic deviated nasal septum cases: a prospective study. Int J Otorhinolaryngol Head Neck Surg 2018;4:800-7.
  11. Ogura JH, Nelson JR., Dammkoehler R., Kawasaki M., Togawa K. Experimental observations of the relationships between upper airway obstruction and pulmonary function. Annals of Otolaryngology 1964;73:381-403.
  12. Amer S, Abdullah D, Ammar M. Assessment of nasal septal deformities by anterior rhinoscopy and nasal endoscopy. Tikrit Med J.2010;16(1):14-20.
  13. Poirrier AL, Ahluwalia S, Goodson A, Ellis M, Bentley M, Andrews P. Is the SinoNasal Outcome Test-22 a suitable evaluation for septorhinoplasty? Laryngoscope. 2013; 123(1):76-81. doi:10.1002/lary.23615
  14. Morianga M, Nakata S, Yasuma F, Noda A, Yagi H, Tagaya M, et al. Pharyngeal morphology: a determinant of successful nasal surgery for sleep apnea. Laryngoscope. 2009 May;119(5):1011-6.
  15. Dogan OT, Yildirim A, Epozturk K, Dogan M. Another advantage of nasal septal suturing: pulmonary function unaffected. B-ENT.2012;8(1):21-4.
  16. Karaman M, Tek A, Tuncel A, Erdem Habesoglu T. Evaluation of patients with septal deviation using respiratory function tests before and after septoplasty. Kulak Burun Bogas Bas Boyun Cerrahi Derg.2011;19(1):1-5.
  17. Niedzielaska G, Kotowski M, Niedzielski A. Assessment of pulmonary function and nasal flow in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2008 Mar; 72(3):333-5.
  18. Boas AP, Marson FA, Ribeiro MA, Sakano E, Conti PB, Toro AD, et al. Walk test and school performance in mouth-breathing children. Braz J Otorhinolaryngol. 2013 Mar-April;79(2):212-8.
  19. Borghi-Silva A, Mendes RG, Trimer R, Oliveira CR, Fregonezi GA, Resqueti VR, et al. Potential effect of 6 versus 12-weeks of physical training on cardiac autonomic function and exercise capacity in chronic obstructive pulmonary disease. Eur J Phys Rehabil Med. 2015 Apr;51(2):211-21.
  20. S Prakash, B Pradhan,N M Thapa. Reliability of sino-nasal outcome test in measuring the outcome of septoplasty. Society of Otorhinolaryngologists of Nepal.2011 Jan-Jun ; 2(1):8-11.
  21. Ho WK, Yuen AP, Tang KC,Wei WI, Lam PK. Time course in the relief of nasal blockage after septal and turbinate surgery. Arch Otolaryngol Head Neck Surg 2004;130:324-8.
  22. Jessen M, Ivarsson A, Malm L. Nasal airway resistance and symptoms after functional septoplasty: comparison of findings after 9 months and 9 years. Clin Otolaryngol Allied Sci 1989;14:2314.

Corresponding Author

Apurva Anil Jarandikar

A-1, Sunder Baug, PCMC Link Road, Chinchwad, Pune, Maharashtra, India – 411033