Unilateral and bilateral effects of nasal septum surgery demonstrated withacoustic rhinometry, rhinomanometry, and subjective assessment

Little is known of what happens after art operative correction of nasal sep tum deviation in the cavity contralateral to the major septum deviation. We studied the effects of septoplasty on the objective and subjective unilate ral and bilateral nasal airway 117 consecutive patients presenting for sept oplasty due to a clinically obstructing septum deviation. Significant media n increases in nasal flow and cross-sectional areas were noted postoperativ ely on the deviation side, whereas on the contralateral sine the nasal flow and the cross-sectional area at the nasal valve (MCA1) decreased significa ntly, 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 note d in the bilateral assessment postoperatively lit these parameters. In the subjective assessment 40% of patients were totally free front nasal obstruc tion postoperatively and the sensation of obstruction was low in 35%. An in verse correlation was found between the postoperative satisfaction and the decrease in MCA1 on the wide side (r = -0.21, p = 0.03) and positive correl ations between the postoperative satisfaction and the increase in MCA1 on t he 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;r; on th e deviation side, but not with the bilateral parameters. In conclusion, it was demonstrated with an objective and subjective assessment that correctio n of a septum deviation may induce harmful effects to the valve ai-ea on th e side contralateral to a deviation. However, postoperatively the overall r elief of nasal obstruction was good and the satisfaction high in most patie nts.