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Concurrent Septorhinoplasty and Functional Endoscopic Sinus Surgery Comparable to Sole Surgeries in Patient Satisfaction

by Linda Kossoff •

CLINICAL QUESTION

What is the postsurgical satisfaction level of patients with nasal symptoms and sinus problems who receive concurrently performed septorhinoplasty (SRPL) and functional endoscopic sinus surgery (FESS)?

BOTTOM LINE

Disease-specific quality of life (QoL) is improved with SRPL, FESS, and combined surgery, and combining the procedures does not compromise QoL gain.

BACKGROUND: Both SRPL and FESS are commonly performed surgeries that can significantly improve disease-specific QoL measures of patients who suffer from nasal symptoms or sinus problems. Studies show that concurrent SRPL and FESS are safe, but patient satisfaction has barely been investigated in concurrent surgery.

STUDY DESIGN: Prospective cohort study.

SETTING: Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital, Heidelberg, Germany.

SYNOPSIS: A total of 267 patients (55.8% female, mean age 29.9 years) received either sole FESS due to chronic rhinosinusitis (CRS) (57 patients, 54.4% male, mean age 34.6 years), sole SRPL (148 patients, 85% female, mean age 28.5 years), or concurrent surgery (62 patients, 61.3% female, mean age 29.1 years). All procedures were performed by the same surgeon between 2019 and 2022. Pre-surgery, patients completed questionnaires: the Sino-Nasal Outcome Test-22 (SNOT-22) for patients with CRS and the Functional Rhinoplasty Outcome Inventory (FROI-17) and Rhinoplasty Outcome Evaluation (ROE) for patients receiving SRPL. Follow-up included clinical examinations two weeks post-surgery and then after 6 and 12 months. Mean QoL scores improved significantly in all groups and all questionnaires postoperatively. Improvement was slightly higher in the single-surgery groups than the combined surgery group but were only statistically significant in the ROE measurement (+58.8 vs. +55.2, respectively). The FROI-17 total scores were +49 for single surgery and +49 for combined; SNOT-22 scores were +34.5 for single and +33.1 for combined. Study limitations included the one-year follow-up period, which may miss later symptom recurrence.

CITATION: Bulut OC, Lippert BM, Riedel F, et al. Quality of life improvement in concurrent septorhinoplasty and endoscopic sinus surgery. Laryngoscope. 2024;134:1239–1245.