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.