Cross-cultural adaptation and validation of Lithuanian-NOSE scale

Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta-analysis

OBJECTIVE

Septoplasty is the most frequently performed ENT surgery to correct nasal septal deviation (NSD). The present study aimed to quantify the effectiveness of septoplasty with or without turbinate surgery according to NOSE questionnaire scores, with the hypothesis that it is able to clinically improve patient-reported nasal obstructive symptoms in the post-operative follow-up.

METHODS

An electronic search was performed on PubMed/MEDLINE, Embase, and Cochrane Library. The primary outcome was the change in NOSE score at 6 months after surgery. It was assessed with the mean difference (MD) between baseline and postoperative results.

RESULTS

A total of 2577 patients (males: 65.1%, 95% CI: 59.9-70.2) with a mean age of 33.3 years (n = 1456, 95% CI: 30.4-36.2) were included in this meta-analysis. The pooled baseline NOSE mean score was 68.1 (n = 2577, 95% CI: 64.3-71.9). The pooled MD in NOSE score at 6-months follow-up compared to baseline was -48.8 (n = 1730, 95% CI: -54.6 to -42.9).

CONCLUSIONS

Functional septoplasty with or without turbinate surgery shows a critical improvement of obstructive symptoms and quality of life according to the validated NOSE score.

LEVEL OF EVIDENCE

NA Laryngoscope, 133:3237-3246, 2023.

Translation and Validation of the Thai Version of the Nasal Obstruction Symptom Evaluation (NOSE) Scale

Objective

The Nasal Obstruction Symptom Evaluation (NOSE) was developed to evaluate subjective outcomes of patients with deviated nasal septum and symptomatic nasal obstruction. Considering the differences in individuals' cultural, cross-cultural translation, adaptation, and validation of the instrument are necessary. The current study aimed to translate and validate the Thai version of the NOSE Questionnaire for patients with nasal septum deviation.

Study Design

A single-center prospective instrument validation study.

Setting

Thai tertiary referral center.

Methods

The study was conducted to translate and adapt the original English version of the NOSE to Thai. After translating, psychometric testing was conducted. The primary outcomes were validity (content, construct, and discriminant), reproducibility (test-retest procedure), and internal consistency (reliability). A total of 105 participants, of which 46 were patients with nasal airway obstruction and 59 were healthy asymptomatic volunteers, were enrolled in this study.

Results

The Thai-NOSE was found to be adequate for all tested psychometric properties with high internal consistency (Cronbach's α = .942), and to discriminate accurately between patients and healthy controls. The interitem and item-total correlations indicated a related construct among all items. A high level of reproducibility of the questionnaire was obtained in the test-retest procedure for each item (γ = 0.898). The initial test and retest scores indicated adequate reproducibility.

Conclusion

The Thai-NOSE questionnaire is a reliable instrument with appropriate psychometric properties for assessing the severity and impact of nasal airway obstruction in patients with nasal septum deviation.

Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft

Background/Aim: Nasal obstruction is caused mainly by nasal septal deviation, and submucosal resection is usually performed to treat this problem. However, if over-resected, nasal tip deprojection, deprojection of the dorsum, or pseudo-hump formation may be seen. Spreader grafts are used to restore the nasal septum in these cases, and different techniques have been described for this restoration; however, these techniques may not be the best fit for such restoration. This study presents a novel and effective method for septal reconstruction in patients with previous septal resections. Methods: Between March 2012 and October 2014, a case series of 14 male patients with tip deprojection and pseudo-hump formation who had undergone corrective surgery in our clinic was retrospectively examined. Partial-split, caudal extension costal spreader grafts were used and were fixed to the dorsum of the remnant septum cranially to prevent warping while avoiding nasal dorsum widening. Pre- and post-operative comparisons were performed, and the Nasal Obstructive Symptoms Evaluation questionnaire for the functional results and subjective Esthetic Appearance test for the esthetic outcomes were administered. Results: The mean age was 36.8 years (19–56 years), and the mean follow-up time was 14.6 months. Functional outcomes and esthetic appearance led to significantly improvements in all post-operative categories (P < 0.05) without any major complications. Common complaints were usually the same as seen in conventional rhinoplasty procedures, such as facial swelling, nasal stuffiness, pain, and/or epistaxis. None of the patients requested revision surgery. Conclusion: Using partial-split, caudal extension costal spreader grafts in the reconstruction of dorsocaudal septum in patients with previous septal resections appears to provide favorable functional and esthetic results.