Predictive factors of patients' general quality of life after nasal septoplasty

PurposeAlthough septoplasty is considered to be the definitive treatment of septal deviation and is associated with an increase of nasal patency, patients are not always satisfied with the surgical outcome as assessed by its effect on their general Quality of Life (QOL).The aim of this study was to identify the predictive factors that influence the patients' QOL after surgery.Methods60 patients with nasal obstruction and septal deviation were enrolled in this prospective study, and they all completed the follow-up survey of 6 postoperative months. Symptom severity (Nasal Obstruction Symptom EvaluationNOSE, Sino nasal outcome test 22SNOT-22), sleep quality (Epworth Sleepiness ScaleESS), olfactory function (Threshold Discrimination IdentificationTDI score), voice quality (Nasalance score and Voice Handicap IndexVHI), stress (SQ test) and emotional status (Beck Depression IndexBDI) were evaluated as predictive factors of patients' QOL (Glasgow Benefit InventoryGBI) postoperatively. We also analyzed age, gender, smoking, socioeconomic status, type of septal deviation and changes of nasal patency (with the use of rhinomanometry, acoustic rhinometry, and peak nasal inspiratory flow).ResultsFrom all the analyzed parameters, the nasal obstruction symptom severity, the sleep quality, and stress levels were only significantly associated with patients' overall QOL (p<0.05; univariate analysis). However, on multiple regression, positive changes in NOSE score (OR 15.09, 95% CI 1.47-22.64, p<0.05) and SQ test (OR 4, 95% CI 1.12-14.3, p<0.05) were only related with higher likelihood of participants' QOL improvement after surgery.ConclusionsThorough preoperative evaluation of the symptom severity and stress levels is critical as these two factors are predictive of patient's satisfaction after septoplasty.