Unilateral and bilateral effects of nasal septum surgery demonstrated with acoustic rhinometry, rhinomanometry, and subjective assessment.

Little is known of what happens after an operative correction of nasal septum deviation in the cavity contralateral to the major septum deviation. We studied the effects of septoplasty on the objective and subjective unilateral and bilateral nasal airway in 117 consecutive patients presenting for septoplasty due to a clinically obstructing septum deviation. Significant median increases in nasal flow and cross-sectional areas were noted postoperatively on the deviation side, whereas on the contralateral side the nasal flow and the cross-sectional area at the nasal valve (MCA1) decreased significantly, the median decreases being 19% (p = 0.022) in the flow and 22% (p = 0.0001) in MCA1 before decongestion and correspondingly 22% (p = 0.004) and 21% (p = 0.0001) after decongestion. Only slight median increases were noted in the bilateral assessment postoperatively in these parameters. In the subjective assessment 40% of patients were totally free from nasal obstruction postoperatively and the sensation of obstruction was low in 35%. An inverse correlation was found between the postoperative satisfaction and the decrease in MCA1 on the wide side (r = -0.21, p = 0.03) and positive correlations between the postoperative satisfaction and the increase in MCA1 on the deviation side (r = 0.26, p = 0.0042) and with the bilateral increase in MCA1 (r = 0.20, p = 0.02). The preoperative subjective sensation of nasal obstruction correlated significantly with the objective parameters on the deviation side, but not with the bilateral parameters. In conclusion, it was demonstrated with an objective and subjective assessment that correction of a septum deviation may induce harmful effects to the valve area on the side contralateral to a deviation. However, postoperatively the overall relief of nasal obstruction was good and the satisfaction high in most patients.

Trends in chronic maxillary sinusitis that require surgical treatment in northern Finland.

To examine trends in the incidence of chronic maxillary sinusitis that require surgical treatment in northern Finland, a retrospective population-based survey from 1974 through 1995 was conducted. Data on surgical cases and on various demographic factors and on variables describing medical care in the area were collected for every third year. The overall crude incidence rate (per 100,000 person-years) of chronic maxillary sinusitis requiring surgical therapy was 44 for children and 76 for adults. The age-standardized incidence rate dropped by 78% in children, and by 66% in adults during the period. The changes found to have taken place in the population and in medical care and which could have promoted the decrease were higher educational level and mean income, smaller families, improved level of hygiene, a higher number of physicians and an expanded use of broader-spectrum antibiotics. In conclusion, the most serious forms of chronic maxillary sinusitis, that require operative treatment, are decreasing in both children and adults in northern Finland.