A study to assess the usefulness of a portable spirometer to quantify the severity of nasal septal deviation

An objective measure of the severity of septal deviation would help the surgeon to select patients, and could also be used to assess the effectiveness of surgery. The aim of this study was to determine the usefulness of a portable spirometer to assess the severity of septal deviation.

Six healthy subjects and 26 patients awaiting nasal septal surgery for the treatment of chronic complaint of nasal obstruction were recruited. The severity of septal deviation was calculated as a nasal partitioning ratio (NPR) determined by rhinomanometry (NPRcon) and spirometry (NPRvol). NPR is expressed as a ratio scale, where -1 equals complete left side obstruction, zero equates to equal airfow on each side of the nose, and 1 equals complete right side obstruction.

The spirometer proved to be useful in measuring the degree of septal deviation in terms of NPRvol (range from -0.21 to 0.20 in healthy subjects, and -0.66 to 1.0 in patients awaiting surgery). The correlation between NPRvol and NPRcon was good (r = 0.77, p = 0.01). In 20 out of 26 patients there was agreement on the side of septal deviation as determined by patient's subjective assessment and the objective assessment with spirometry.

The results demonstrate that the severity of septal deviation may be quantified in terms of a nasal partitioning ratio determined by use of a portable spirometer (NPRvol). This new measure of septal deviation may prove to be useful to the surgeon in selecting patients for septal surgery and in measuring the success of septal surgery.