[Clinical success of surgical correction of the nasal septum]

We conducted a retrospective survey on patient's evaluation of the outcomes of surgery for a deviated nasal septum.

In January 1995 all working members of a German health insurance plan who were hospitalized between March and September 1994 for ICD-470 (n = 392) were surveyed using a self-administered pretested questionnaire. The response rate was 85.2% (n = 334, 88.8% male; medium age: 35.2 years, average length of stay: 6.5 days). Descriptive and multivariate analysis (GSK model) were preformed. Relative alleviation of symptoms was taken as an indicator for clinical outcome.

The most important reasons for undergoing septal surgery from the patient's point of view were nasal obstruction (52%), headache (8.7%) and snoring (7.8%). Ten point six percent of the study population reported complete disappearance of preoperative symptoms (100% relative improvement), whereas in 7.9% no symptom alleviation of nasal related symptoms was described. Postoperative complications were reported by 29.9% of the respondents (i.e., adhesions: 5.7%; perforations; 2.1%). Multivariate analysis revealed that the relative improvement of symptoms increases if no nasal packing is administered, if the patients report minor postoperative discomfort only, and if no postoperative complications appear.

The clinical outcome of septal surgery is similar compared to that of other studies, but may be improved by not applying postoperative nasal packings. For some of the surgical complications we found higher rates than those that have been reported so far. The results may offer opportunities for clinical audit and quality management.