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82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

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Nasal spirometry in the preoperative selection of patients for septoplasty

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  • corresponding author Georgios Fyrmpas - Katerini Hospital, Katerini, Greece
  • Dionysios Kyrmizakis - Veria Hospital, Veria, Greece
  • Victor Vital - AHEPA 1st Academic ORL Department, Thessaloniki, Greece
  • Jannis Constantinidis - 2nd Academic ORL Department, Thessaloniki, Greece

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Freiburg i. Br., 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hnod590

doi: 10.3205/11hnod590, urn:nbn:de:0183-11hnod5907

Published: April 19, 2011

© 2011 Fyrmpas et al.
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Outline

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Introduction: there is no consensus over the best approach to selection of patients for septoplasty. Clinical examination is often inadequate and objective testing has not gained wide popularity due to technical, cost and training issues. The aim of this study was to evaluate bilateral nasal spirometry (BNS) as a quick and easily interpretable method of selecting appropriate candidates for septoplasty. BNS measures airflow asymmetry caused by a nasal septal deviation (NSD) and it is expressed as the nasal partitioning ratio (NPR). The NPR after decongestion can be used as an objective measure of the degree of NSD. NPR ranges from –1 (complete left nasal obstruction) to +1 (complete right nasal obstruction).

Patients/methods: Thirty patients (25 males/5 females, mean age 33 years) with nasal obstruction and a NSD were assessed by subjective measures (NOSE score, 10 cm visual analogue scale, 10-point double vertical scale) and the BNS before and after septoplasty. Thirty healthy controls (25 males/5 females, mean age 31.7 years) were recruited for providing a reference range of NPR values.

Results: All patients were subjectively improved after septoplasty but only those with NPR out of the normal limits (–0.25 to 0.24) had a significant reduction of NSD (Wilcoxon Signed ranks test, p<0.001). No correlation between subjective measures of nasal obstruction and NPR was observed.

Conclusion: BNS is a rapid, easily interpretable, noninvasive technique which identifies patients with large NSDs who, irrespective of concomitant mucosal factors of nasal obstruction, warrant septoplasty. BNS is unreliable in cases of a septal perforation or an S type NSD and it cannot detect an insufficient nasal valve.