[Subjective and objective evaluation and correlation analysis of pre- and post- operation in patients with structural...

Objective: To analyze the subjective and objective results and the correlation of nasal obstruction because of nasal structural variation pre and post operation, and to provide clinical evidence for surgery and curative effect. Methods: Three groups were included in this study: group 1 were 78 patients with structural rhinitis, group 2 were 72 patients with chronic sinusitis (without nasal polyp) and group 3 were healthy controls of 75 cases. Assessment of nasal obstruction was achieved by visual analog scale (VAS), and objective measurement was achieved by rhinomanometry and acoustic rhinometry. The first two minimum cross-sectional area of nasal cavity (MCA1, MCA2), their distances from the nostrils (MD1, MD2) and the nasal volume of 5 cm depth from the nostril (NV5) were recorded. The ratio of the parameters of the two sides of the nasal cavity was calculated respectively. Nasal resistance total (RT) and calculated right-left nasal resistance ratio (Rlr) were recorded. Patients of group 1 and group 2 accepted endoscopic surgery and received the above evaluation again at three months after surgery. Three groups were compared with statistical test. Results: The preoperative values of three groups (MCA1, MD1, MCA2, MD2, NV5, RT) showed no statistical significance (F value was 0.945, 0.245, 1.380, 0.036, 0.866, 1.651, respectively; all P>0.05), while their ratio had statistical differences except MD1 (F value was 5.242, 1.726, 4.882, 4.005, 5.066, 5.316; P=0.013, 0.199, 0.019, 0.024, 0.018, 0.011, respectively). Statistical results between the ratio of values (MCA1, MD1, MCA2, MD2, NV5, RT) and VAS of nasal obstruction of group 1 and group 2 showed significant positive correlations pre operation(r of group 1 value was 0.471, 0.418, 0.260, 0.324, 0.305, 0.459, respectively; r of group 2 value was 0.373, 0.403, 0.288, 0.366, 0.402, 0.249, respectively; all P<0.05). VAS scores pre and post operation of group 1 had statistically difference (t=35.122, P<0.05). Postoperative value of MD1, MD2 and RT among three groups had no statistical difference (F value was 0.178, 0.582, 0.905, respectively; all P>0.05). Postoperative value of MCA1, MCA2, NV5 among three groups had statistical difference (F value was 4.010, 5.126, 4.901, respectively; all P<0.05). Postoperative ratio of MCA1, MD1, NV5 and Rlr among three groups had no statistical difference (F value was 1.023, 0.944, 0.524, 0.996, respectively; all P>0.05). Postoperative ratio of MCA2 and MD2 among three groups had statistical difference (F value was 4.859, 4.357, respectively; all P<0.05). Conclusion: Severity of nasal obstruction is related to structural variation of nasal cavity and the purpose of surgery is to restore structural symmetry of bilateral nasal cavity.