The Role of Nasal Endoscopy in the Preoperative Evaluation of Nasal Airway Obstruction.

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Clinical Guidelines
Authored By
Gardiner LA, Goyal LK, McCoy JL, Gillman GS
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ENT
Emergency Medicine
Surgery
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Surgery
Emergency Medicine
ENT
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volume
169
ISSN
1097-6817
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1097-6817
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["Gardiner LA, Goyal LK, McCoy JL, Gillman GS","Publisher: Wiley Country of Publication: England NLM ID: 8508176 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6817 (Electronic) Linking ISSN: 01945998 NLM ISO Abbreviation: Otolaryngol Head Neck Surg Subsets: MEDLINE","Journal Article","2023-11-01","Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Nov; Vol. 169 (5), pp. 1329-1334. Date of Electronic Publication: 2023 May 03.","English","1097-6817","Nasal Obstruction*\/diagnosis , Nasal Obstruction*\/surgery , Rhinoplasty*\/methods, Humans ; Cross-Sectional Studies ; Nose\/surgery ; Endoscopy\/methods ; Nasal Septum\/surgery","Humans, Cross-Sectional Studies, Nose surgery, Endoscopy methods, Nasal Septum surgery, Nasal Obstruction diagnosis, Nasal Obstruction surgery, Rhinoplasty methods","Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery","169"]
Description
Objective: To examine the prevalence and nature of nasal endoscopic findings in patients referred for structural nasal obstruction, and analyze how such findings influence the preoperative evaluation or operative plan.<br />Study Design: Cross-sectional study.<br />Setting: University-based academic otolaryngology practice.<br />Methods: Nasal endoscopy was performed by a single surgeon and the exam findings were documented. Patient demographics, variables in the patient history, Nasal Obstruction Symptom Evaluation scores, and an Ease-of-Breathing Likert Scale were tested for associations with findings on endoscopy.<br />Results: A total of 82 of 346 patients (23.7%) had findings on rigid nasal endoscopy not appreciable on anterior rhinoscopy. Prior nasal surgery (p = .001) and positive allergy testing (p = .013) were significantly associated with findings on nasal endoscopy. Endoscopic findings prompted additional preoperative studies in 50 (14.5%) patients, and a change in the operative plan in 26 (7.5%) patients.<br />Conclusion: In patients referred for surgical management of nasal obstruction, findings on nasal endoscopy otherwise undetected with anterior rhinoscopy are most common in but certainly not limited to those with prior nasal surgery or allergic rhinitis. Routine nasal endoscopy should be considered for all patients being evaluated for nasal airway surgery. These results may benefit future updates of the clinical consensus statements regarding the role of nasal endoscopy in the evaluation of nasal valve compromise and septoplasty.<br /> (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
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