The use of acoustic rhinometry in predicting outcomes after sinonasal surgery

Today's healthcare environment demands objective assessment of surgical out comes. The recent otolaryngologic literature has established acoustic rhino metry (AR) as a valid instrument to objectively document nasal patency. The purpose of this article is to evaluate the utility of AR in predicting out comes after sinonasal surgery. All patients scheduled for sinonasal surgery at the Tulane University and University of Mainz Departments of Otolaryngo logy between 10/1/98 and 12/15/98 were enrolled. All subjects underwent AR and completed a sinonasal outcome survey (SNOT-20) one day before and two m onths after their surgical procedure. Thirty-one patients were enrolled. Th e SNOT-20 raw scores improved from a mean of 7.93 (+/-3.78) preoperatively to 3.35 (+/-2.33) postoperatively (p < 0.05). The I-notch revealed no signi ficant change postoperatively. The mean bilateral predecongestion C-notch i ncreased from 1.257 cm(2) to 1.451 cm(2) (p < 0.05). Patients with a bilate ral C-notch >1 cm(2) were 1.96 times more likely to have a five-point impro vement in the SNOT-20 raw score (95% CI = 1.17 3.27). The mean value of the C-notch is significantly altered (increased) as a result of sinonasal surg ery. Patients with a preoperative cross-sectional area <1 cm(2) are less li kely to report large postoperative subjective improvement. These results in dicate that patients with poor geometry at the area of the C-notch do not f are as well surgically as those with better preoperative measurements.