The effectiveness of septoplasty performed based on preoperative prognostic determination of the volume of surgical correction of the internal nasal valve structures through its bioimaging planimetry

Shkorbotun V.O.,Ovsiienko M.O.

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The effectiveness of septoplasty performed based on preoperative prognostic determination of the volume of surgical correction of the internal nasal valve structures through its bioimaging planimetry

August 16, 2024

289

УДК: 616.212.5-07-036.3-089-037

DOI: 10.32471/umj.1680-3051.166.256700

Keywords :

computed tomography,

endoscopy,

nasal cavity,

nasal septum deviation,

olfactory dysfunction,

Specialities :

Resume

Objective: Increasing the effectiveness of septoplasty by prognostic substantiation of the optimal volume of surgical intervention on the structures of the anterior and upper parts of the nose on the basis of preoperative videoendorhinoscopy examination with computer bioimaging of images of the nasal cavity and planimetry of its lumen.

Materials and methods. 108 patients who underwent surgery for nasal septum deformation and nasal breathing disorders were examined. The first group comprised 66 patients who were retrospectively assessed after septoplasty performed using the traditional Cottle surgery, with some also undergoing correction of the inferior nasal valve (INV) as determined by the surgeon visually during the procedure. The second group included 42 patients who underwent septoplasty using the traditional Cottle surgery, with the decision to correct the INV based on predictions derived from differences between real and theoretically justified boundaries, as determined from photo images of video endorinoscopy. In all patients, quality of life was assessed using the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire, and computerized anterior active rhinomanometry and olfactometry tests were conducted using «Sniffin’Sticks».

Results. According to the «Sniffin’ Sticks» tests, the overall olfactory acuity index was 9.48±0.18 points in patients of Group I and 10.45±0.18 points in patients of Group 2 (p<0.05). It was also found that the quality of life outcomes after septoplasty were significantly better in patients of Group 2 compared to those in Group 1.

Conclusion. The effectiveness of septoplasty, with prediction of the extent of surgical intervention on the structures of the anterior and upper parts of the nose based on preoperative videoendorhinoscopy examination and computer bioimaging processing of INV images, is higher compared to the traditional approach by 20.8% according to the SNOT-22 indicator (from 69.7% to 90.5%; p<0.05).

References

1. Alanazy S., AlQuniabut I., Alenezi M.M. et al. (2022) Quality of life and symptoms before and after nasal septoplasty with or without turbinoplasty compared with control individuals in Saudi Arabia. J. Craniofac. Surg., 34(3): 922–925. doi: 10.1097/scs.0000000000009115.
2. Papadopulos N.A., Liebmann J., Kloeppel M. et al. (2021) Quality of Life after Rhinoplasty: A Prospective Study. Facial Plastic Surgery, 37(05): 639–645. Available from: doi.org/10.1055/s-0041-1725174.
3. Dąbrowska-Bień J., Skarżyński H., Górski S.F. (2021) Quality of Life in Patients with Nasal Obstruction after Septoplasty: A Single Institution Prospective Observational Study. International Archives of Otorhinolaryngology, 25(04): e575–e579. doi.org/10.1055/s-0040-1722162.
4. Fokkens W., Lund V., Mullol J. (2020) European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology (Amsterdam Online)/Rhinology, 0(0): 1–464. doi.org/10.4193/rhin20.600.
5. Van Egmond M.M.H.T., Grutters J.P.C., Hannink G.J. et al. (2020) Septoplasty versus non-surgical management for nasal obstruction in adults with a deviated septum: economic evaluation alongside a randomized controlled trial. BMC Medicine, 18(1). doi.org/10.1186/s12916-020-01562-5.
6. Srinivasan D.G., Hegde J., Ramasamy K. et al. (2021) Comparison of the Efficacy of Septoplasty with Nonsurgical Management in Improving Nasal Obstruction in Patients with Deviated Nasal Septum — A Randomized Clinical Trial. Int. Arch. Otorhinolaryngol., 26(02): e226–e232. doi.org/10.1055/s-0041-1730993.
7. Carrie S., O’Hara J., Fouweather T. et al. (2023) Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial. BMJ, e075445. doi.org/10.1136/bmj-2023-075445.
8. Bugten V., Nilsen A.H., Thorstensen W.M. et al. (2016) Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals. BMC Ear, Nose and Throat Disorders, 16(1). doi.org/10.1186/s12901-016-0031-7.
9. Cantone E., Iengo M. (2020) Why does general QOL tend to worsen over time following septoplasty even in the absence of worsening nasal symptoms? Indian J. Otolaryngol. Head and Neck Surg., 74(S2): 1134–1137. doi.org/10.1007/s12070-020-02208-x.
10. Gillman G.S., Egloff A.M., Rivera‐Serrano C.M. (2013) Revision septoplasty: A prospective disease‐specific outcome study. the Laryngoscope, 124(6): 1290–1295. doi.org/10.1002/lary.24356.
11. Althobaiti K.H., Fida A.R., Almahmoudi A. et al. (2022) Common Causes of failed septoplasty: A Systematic review. Curēus. doi.org/10.7759/cureus.33073.
12. Subbaraj R., Mathews S.S., Bedford S. et al. (2022) Effect of the nasal airflow inducing manoeuvre on olfaction and quality of life after laryngectomy. J. Laryngol. Otol., 137(3): 273–278. doi.org/10.1017/s0022215122000810.
13. Шкорботун В. (2022) Стан нюхової функції та її вплив на якість життя пацієнтів залежно від порушення прохідності носових ходів. Укр. мед. часопис, 147. doi.org/10.32471/umj.1680-3051.147.226553.
14. Shkorbotun V.O., Ovsiienko M.O., Shkorbotun Y.V. (2024) Relative metric indicators of the upper and lower parts of the internal nasal valve lumen and their impact on nasal respiratory and olfactory functions. Klìnìčna Ta Profìlaktična Medicina, 1: 18–24. doi.org/10.31612/2616-4868.1.2024.02.
15. Borojeni A.T., Garcia G.J.M., Moghaddam M.Gh. et al. (2019) Normative ranges of nasal airflow variables in healthy adults. Int J. Comp. Assist Radiol Surg., 15(1):87–98. doi.org/10.1007/s11548-019-02023-y.
16. Xiong G.X., Zhan J.M., Jiang H.Y. et al. (2008) Computational fluid dynamics simulation of airflow in the normal nasal cavity and paranasal sinuses. Am. J. Rhinol., 22(5): 477–482. doi.org/10.2500/ajr.2008.22.3211.
17. Zhao K., Jiang J. (2014) What is normal nasal airflow? A computational study of 22 healthy adults. International Forum of Allergy and Rhinology, 4(6): 435–446. doi.org/10.1002/alr.21319.
18. Jankowski R., Gallet P., Nguyen D., Rumeau C. (2020) Septoplasty by disarticulation. European Annals of Otorhinolaryngology, Head and Neck Diseases, 137(5): 423–426. doi.org/10.1016/j.anorl.2020.07.014.
19. Cottle M.H., Loring R.M. (1946) Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology. Illinois Med. J., 90: 119–135.
20. Shkorbotun Y. (2020) Evaluation of the ukrainian version of snot-22 questionnaire validity for assessing the quality of life in patients with chronic rhinosinusitis and nasal septum deviation. Georgian medical news, 308: 43–47. pubmed.ncbi.nlm.nih.gov/33395639/.
21. Hummel T., Sekinger B., Wolf S.R. et al. (1997) «Sniffin’ Sticks»: Olfactory performance assessed by the combined testing of odour identification, odor discrimination and olfactory threshold. Chemical Senses, 22(1): 39–52. doi.org/10.1093/chemse/22.1.39.
22. Shafik A.G., Alkady H.A., Tawfik G.M. et al. (2020) Computed tomography evaluation of internal nasal valve angle and area and its correlation with NOSE scale for symptomatic improvement in rhinoplasty. Brazilian J. Otorhinolaryngol., 86(3): 343–350. doi.org/10.1016/j.bjorl.2019.08.009.
23. Toma S., Hopkins C. (2016) Stratification of SNOT-22 scores into mild, moderate or severe and relationship with other subjective instruments. Rhinology (Amsterdam Online)/Rhinology, 54(2): 129–133. doi.org/10.4193/rhino15.072.
24. Chambers K.J., Horstkotte K.A., Shanley K., Lindsay R.W. (2015) Evaluation of improvement in nasal obstruction following nasal valve correction in patients with a history of failed septoplasty. JAMA Facial Plastic Surgery, 17(5): 347–350. doi.org/10.1001/jamafacial.2015.0978.
25. Shkorbotun V.O., Ovsiienko M.O. (2022) Impact of the nasal valve shape on the olfactory function and subjective perception of the nasal breathing. Wiadomości Lekarskie, 75(11): 2640–2645. doi.org/10.36740/wlek202211116.
26. Pedersen L., Schiöler L., Finjan S. et al. (2019) Prognostic factors for outcome after septoplasty in 888 patients from the Swedish National Septoplasty Register. European Archives of Oto-rhino-laryngology/European Archives of Oto-rhino-laryngology and Head & Neck, 276(8): 2223–2228. doi.org/10.1007/s00405-019-05440-6.
27. Carrie S., Fouweather T., Homer T. et al. (2024) Effectiveness of septoplasty compared to medical management in adults with obstruction associated with a deviated nasal septum: the NAIROS RCT. HTA on DVD/Health Technology Assessment, 1–213. doi.org/10.3310/mvfr4028.
28. Hsu H.C., Tan C.D., Chang C.W. et al. (2016) Evaluation of nasal patency by visual analogue scale/nasal obstruction symptom evaluation questionnaires and anterior active rhinomanometry after septoplasty: a retrospective one‐year follow‐up cohort study. Clin. Otolaryngol., 42(1): 53–59. doi.org/10.1111/coa.12662.
29. Kang X.R., Chen B., Chen Y.S. et al. (2020) A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study. Peer J., 8: e9890. doi.org/10.7717/peerj.9890.
30. Liu J., Yan Z., Zhang Z., Wang N. (2021) Septoplasty alone is not suitable for most structural nasal obstructions. World Journal of Otorhinolaryngology-head and Neck Surgery, 7(4): 322–327. doi.org/10.1016/j.wjorl.2020.05.007.