Effect of Functional Septorhinoplasty with Concha Bullosa Resection on Sinonasal Symptoms

Abstract

Objective To evaluate the impact of functional septorhinoplasty (SRP) with and without concha bullosa resection (CBR) on sinonasal symptoms and nasal obstruction severity using the Nasal Obstruction Symptom Evaluation (NOSE) and Sino-Nasal Outcome Test-22 (SNOT-22) scale. Methods Consecutive adult participants who underwent SRP were retrospectively analyzed. Patients were divided into two groups: Group 1 (SRPwCB) underwent SRP with CBR (bulbous or extensive type MTs), and Group 2 (SRPO) underwent SRP only (normal or lamellar-type MTs). The NOSE and SNOT-22 scales were assessed preoperatively and at the 3-month follow-up evaluation. Patient demographics, self-reported outcomes, nasoseptal angle (NSA), and Lund-Mackay scores (LMS) were analyzed. Results There were 119 participants (SRPwCB n = 57; SPRO n = 62). There were no statistically significant differences in age, sex, allergy, smoking, LMS, and NSA according to the presence of MTCB. Compared to SRPO, SRPwCB patients had significantly higher preoperative NOSE and SNOT-22 scores, whereas their postoperative NOSE and SNOT-22 scores were similar. SRPwCB patients also had significantly more postnasal discharge, ear fullness, facial pain/pressure, poor sleep, night waking, daytime fatigue, sense of taste/smell, and blockage symptoms before surgery compared with SRPO patients. Conclusion SRPwCB patients had higher nasal obstruction and sinonasal symptom scores and greater improvement after surgery than SRPO patients. Therefore, evaluating the middle turbinate before functional SRP may be an important for surgical treatment of sinonasal symptoms. Level of Evidence 3 Laryngoscope, 2022