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Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial

Objective To assess the clinical effectiveness of septoplasty.

Design Multicentre, randomised controlled trial.

Setting 17 otolaryngology clinics in the UK’s National Health Service.

Participants 378 adults (≥18 years, 67% men) newly referred with symptoms of nasal obstruction associated with septal deviation and at least moderate symptoms of nasal obstruction (score >30 on the Nasal Obstruction and Symptom Evaluation (NOSE) scale).

Interventions Participants were randomised 1:1 to receive either septoplasty (n=188) or defined medical management (n=190, nasal steroid and saline spray for six months), stratified by baseline symptom severity and sex.

Main outcome measures The primary outcome measure was patient reported score on the Sino-Nasal Outcome Test-22 (SNOT-22) at six months, with 9 points defined as the minimal clinically important difference. Secondary outcomes included quality of life and objective nasal airflow measures.

Results Mean SNOT-22 scores at six months were 19.9 (95% confidence interval 17.0 to 22.7) in the septoplasty arm (n=152, intention-to-treat population) and 39.5 (36.1 to 42.9) in the medical management arm (n=155); an estimated 20.0 points lower (better) for participants randomised to receive septoplasty (95% confidence interval 16.4 to 23.6, P<0.001, adjusted for baseline continuous SNOT-22 score and the stratification variables sex and baseline NOSE severity categories). Greater improvement in SNOT-22 scores was predicted by higher baseline symptom severity scores. Quality of life outcomes and nasal airflow measures (including peak nasal inspiratory flow and absolute inhalational nasal partitioning ratio) improved more in participants in the septoplasty group. Readmission to hospital with bleeding after septoplasty occurred in seven participants (4% of 174 who had septoplasty), and a further 20 participants (12%) required antibiotics for infections.

Conclusions Septoplasty is a more effective intervention than a defined medical management regimen with a nasal steroid and saline spray in adults with nasal obstruction associated with a deviated nasal septum.

Trial registration ISRCTN Registry [ISRCTN16168569][1].

The chief investigator and collaborators will act as custodians of the trial data and manage data sharing requests through ReShare, a UK online data repository recommended by the funder. Parties interested in data sharing will directly contact the chief investigator and collaborators and complete a project proforma and provide the rationale and the information required and comply with the regulation of responsibilities of users. If agreed to be appropriate, requested anonymised data will be made available. An access advisor who is independent of the trial team will periodically review access decisions.

[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN16168569

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Loads to see and do for Sleaford RiverLight Festival

Loads to see and do for Sleaford RiverLight Festival
lincolnshireworld.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from lincolnshireworld.com Daily Mail and Mail on Sunday newspapers.

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Ulverston hospice given £84,000 donation by Furness Society

As part of their Affinity Account Scheme, Furness Building Society made the donation that is set to massively help the charity.

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Aditya-L1: India set to launch probe to investigate mysteries of the sun

The Aditya-L1 satellite will sit between the sun and Earth and provide constant observation data to scientists around the world

India , Cambridge , Cambridgeshire , United-kingdom , Helen-mason , University-of-cambridge , Indian-space-research-organisation , Satish-dhawan-space-centre , The-sun ,

Work before play on Cowal lifeboat's day - Argyllshire Advertiser

Work before play on Cowal lifeboat's day - Argyllshire Advertiser
argyllshireadvertiser.co.uk - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from argyllshireadvertiser.co.uk Daily Mail and Mail on Sunday newspapers.

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Ella Yoder | Death Notices | Goshen News

This is a Death Notice for Ella Yoder published on 2023-06-29 in Goshen News

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Traveller Letters: Sydney Airport is an international embarrassment

‘Sydney does not need a second airport. It just needs one that functions above the level of our current one.’

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UK's first all-wheelchair professional dance company performs The Snow Queen to sold-out theatres

Propel Dance, a new professional all wheelchair-user dance company recently concluded their short tour of The Snow Queen, bringing the run of the company’s first ever live performances to a successful close, with one of their performances being held at the Old Library in Mansfield.

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John H. "Jack" Karstetter III, Austintown, Ohio Obituary

April 23, 2023

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Around the Districts: Clonroche to Fethard

CLONROCHE-POULPEASTY

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