Septoplasty: early (first year) and late (fourth year) post-operative results in 604 patients.

OBJECTIVE: As prospective outcomes of septoplasty with or without turbinoplasty beyond the first year are few and have diverging results, this study evaluated later septoplasty results three to four years post-operatively. METHODS: Patients undergoing septoplasty completed the Nasal Surgical Questionnaire pre-operatively, and at 6-12 months (early post-operative assessment) and 36-48 months (late post-operative assessment) after surgery. Primary outcome was visual analogue scale ratings for nasal obstruction (with a scale ranging from 0 to 100). RESULTS: In 604 patients with high response rates, the largest improvements in nasal obstruction were from pre-operative to early post-operative assessments (daytime score reduction = 33.9, night-time reduction 40.5). Nasal obstruction ratings worsened slightly between early and late post-operative assessments (daytime score increase = 5.3, night-time score increase = 9.7). Improvements were better in patients aged over 35 years and in those with pre-operative nasal obstruction scores of more than 62. There were no differences based on surgery type, septal deviation, allergy or smoking. CONCLUSION: Septoplasty improves nasal obstruction in both the first and the fourth year after surgery. Post-operative improvements decline slightly over time but remain significant.

Assessment of non-response in quality control of nasal septal surgery.

OBJECTIVE: This study evaluated the effect of mail non-response on the validity of the results of nasal septal surgery. METHOD: Six months post-operatively, questionnaires with both prospective and retrospective ratings were mailed to patients. Patients who did not respond (non-responders) were contacted by telephone. This study compared two cohorts of patients using different interviewers (a nurse and a surgeon). Cohort one consisted of 182 patients (with 67 per cent mail response), and cohort two consisted of 454 patients (with 64.8 per cent mail response). RESULTS: In both cohorts, the improvement in obstruction scores was significantly better among mail responders than among non-responders (telephone interviewees) using prospective ratings, but worse using retrospective ratings. CONCLUSION: Mail responders had better improvement in nasal obstruction after septoplasty than non-responders. Therefore, low response rates may cause an overestimation of the results. The retrospective ratings obtained through telephone interviews are less reliable because they are influenced by memory and the patients' tendency to give socially acceptable answers.

Evaluation of non-response in quality control of nasal septal surgery.

OBJECTIVE: Questionnaires are often used to assess the results of nasal septoplasty, but response rates vary widely. The possible bias caused by non-responders was evaluated to determine the validity of questionnaire results. METHODS: Post-operative questionnaires employing visual analogue scales for nasal obstruction were mailed to 182 patients. The 62 non-responders (34.1 per cent) were contacted by telephone, 58 (93.5 per cent) of whom were contactable and responded orally to the questionnaire. RESULTS: Non-responders were younger, but no different from responders with regard to gender, smoking habits or allergies. Post-operative visual analogue scale obstruction scores were slightly, but not statistically, higher in non-responders. However, because non-responders' pre-operative scores were lower, obstruction scores improved less than in responders. The main reason for not responding was forgetfulness. Some would have preferred an electronic version of the questionnaire. CONCLUSION: Although post-operative obstruction scores did not differ between the groups, nasal obstruction scores improved more among responders than non-responders. Thus, low response rates may cause bias.