Functional assessment of septo(rhino)plasty revision surgery.

Introduction: Functional septo(rhino)plasty incurs a 17-25% rate of revision for persistent symptoms.

Objectives: The main study objective was to assess functional results before and after surgical revision. The secondary objective was to describe the shortcomings or excesses of the prior surgeries, with a-posteriori comparison of efficacy for the surgical techniques requiring revision.

Material And Methods: A single-center retrospective study included functional salvage septo(rhino)plasties. Data comprised epidemiology, intraoperative anatomic abnormalities indicative of prior surgery, operative correction maneuvers, and pre- and post-intervention NOSE and RhinoQoL scores and satisfaction on VAS.

Results: Eighty-two patients were included. Anatomic abnormalities comprised deviated posterior septum (81.7%) and chondroethmoidal junction (58.5%), valve stenosis (54.9%), and obstructive boney spur or crest (46.3%). Prior surgeries comprised 33 submucosal resections, 29 septorhinoplasties, 14 Cottle septoplasties and 5 Killian procedures. Complete septoplasty was performed in 80% of cases, with associated maneuvers in 15%. All scores showed improvement taking the whole population together (P<10), but on subgroup analysis improvement concerned only revision of septorhinoplasty (P<10) and of submucosal resection (P<10), while 17% of patients showed no change in scores.

Conclusion: Functional nasoseptal salvage surgery enables most patients to recover respiratory comfort, with the exception of a few cases despite a perfectly straight nasal septum.