title: Functional and cosmetic outcomes of external approach septoplasty.
abstract: BACKGROUND
  The external approach for septoplasty is an important surgical technique to manage severe septal deviations, caudal deformities, and mid-dorsal abnormalities when a simple endonasal approach may not suffice. The procedure is longer in duration and draws on more resources than endonasal septoplasty. The outcome reporting of the external approach for septoplasty is important to provide evidence of benefit for both patients and health care providers. This study was designed to describe functional and cosmetic outcomes of the external approach for septoplasty.
  
  
  METHODS
  A prospective assessment of consecutive patients undergoing the external approach for septoplasty at a tertiary center was performed. Pre- and postoperative nasal peak inspiratory flow (NPIF), symptom scores, 22-Item Sinonasal Outcome Test (SNOT-22), Nasal Obstruction Score, and Short Form 36 (SF-36) quality-of-life scores were assessed. A global Likert change scale was also used for both function and cosmesis.
  
  
  RESULTS
  Thirty patients (mean age, 40 ± 15.9 years; 40% women) were assessed with a mean follow-up of 12.2 ± 9.5 months. Mean NPIF improved significantly from 93.3 ± 34.7 to 143.0 ± 44.3 (p < 0.001). Nasal obstruction score improved significantly from 3.6 ± 1.3 to 0.69 ± 1.2 (p < 0.001). SNOT-22 improved significantly from 34.1 ± 17.2 to 12.7 ± 14.9 (p < 0.001). Ninety-six percent had subjective improvement in nasal function, and 96% had no change or improvement in cosmesis. Seventy percent improved by the minimal clinically important difference for NPIF.
  
  
  CONCLUSIONS
  The external approach for septoplasty is an operation that produces significant improvements in subjective and objective nasal health measures. Although requiring greater training and operative time, it is an appropriate approach for the severely deviated nasal septum.
authors.affiliation: Department of Otorhinolaryngology, St. Vincent's Hospital, Sydney, New South Wales, Australia. seamusphillips@hotmail.com
authors.forename: P Seamus
authors.initials: PS
authors.lastname: Phillips
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stow
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Timperley
authors.forename: Raymond
authors.initials: R
authors.lastname: Sacks
authors.forename: Aviva
authors.initials: A
authors.lastname: Srubiski
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
authors.forename: George N
authors.initials: GN
authors.lastname: Marcells
mesh_terms: D000328:Adult; D001944:Breath Tests; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012225:Rhinoplasty / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome