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Septoplasty, Ambulatory Oropharyngeal Surgery Combination Is Safe

by Amy E. Hamaker •

Does septoplasty combined with ambulatory oropharyngeal surgery increase postoperative complications?

Background: Septoplasty, tonsillectomy, and uvulopalatopharyngoplasty (UPPP) are three of the most common surgical procedures performed by otolaryngologists in the United States. Septoplasty is also commonly performed concurrently with oropharyngeal surgery (tonsillectomy and UPPP), however, thanks to increasing awareness that oropharyngeal surgery can improve obstructive sleep apnea (OSA) symptoms, evidence that patients with OSA and nasal obstruction have improved metrics following septoplasty, and requirements for more efficient, cost-effective care.

Study design: Cross-sectional database analysis of 26,280 tonsillectomies alone versus 1,002 tonsillectomies plus septoplasty from 2010-2011.

Setting: State ambulatory surgery databases for New York, Florida, Iowa, and California.

Synopsis: Tonsillectomy alone had a 13.2% overall revisit rate, a 4.9% bleeding rate, a 1.6% fever, nausea, vomiting, and dehydration (FNVD) revisit rate, and a 2.9% acute pain revisit rate, with no mortalities. Septoplasty plus tonsillectomy had a 12.8% overall revisit rate, a 7.0% bleeding rate, a 1.0% FNVD revisit rate, and a 1.1% acute pain revisit rate. UPPP alone had an 11.4% overall revisit rate, a 3.5% bleeding rate, a 1.0% FNVD revisit rate, and a 2.5% acute pain revisit rate, with mortalities. Septoplasty plus UPPP had a 10.1% overall revisit rate, a 3.8% bleeding rate, a 0.7% FNVD revisit rate, and a 0.9% acute pain revisit rate, with no mortalities. UPPP/tonsillectomy alone had an 11.8% overall revisit rate, a 3.9% bleeding rate, a 1.5% FNVD revisit rate, and a 3.3% acute pain revisit rate, with no mortalities. Septoplasty plus UPPP/tonsillectomy had an 8.5% overall revisit rate, a 6.1% bleeding rate, a 0.0% FNVD revisit rate, and a 1.8% acute pain revisit rate, with no mortalities. Limitations include lack of data on immediate postoperative complications, no preoperative patient information, and no data regarding revisits to the clinic instead of the emergency department.

Bottom line: The addition of septoplasty to oropharyngeal ambulatory surgical procedures does not significantly increase the rate of unplanned revisits or postoperative hemorrhage, except in the case of septoplasty plus tonsillectomy.

Citation: Creighton FX Jr., Bhattacharyya N. Does septoplasty performed at the same time as oropharyngeal surgery increase complication rates? Laryngoscope. 2015;125:2828-2831.