title: Improvement of Pulmonary Functions Following Septoplasty: How Are Lower Airways Affected?
abstract: OBJECTIVE
  Nasal septal deviation is a frequent cause of increased nasal airway resistance. A narrow nasal airway would result in a decreased airflow into the lungs. The aim of the present study was to evaluate the alterations of the pulmonary functions following septoplasty using spirometry and 6 minutes walking test (6mWT). And reveal the correlation of symptom score improvement with nasal obstruction symptom score (NOSE) and sino-nasal outcome test (SNOT22) questionnaires following surgery.
  
  
  METHODS
  Thirty patients with obvious nasal septal deviations were enrolled in the study. All patients had a detailed otorhinolaryngologic examination, filled NOSE/SNOT22 questionnaires, performed spirometry and 6mWT preoperatively. One month after surgery, NOSE/SNOT22 questionnaires filled by subjects and spirometry with 6mWT were performed again, and the results were compared.
  
  
  RESULTS
  The mean total walking distance was 702.3±68.2 m preoperatively, and it improved to 753.2±72.6 m postoperatively (P<0.001). Total tour count increased from 11 (range, 10.8 to 12.0) to 12 (range, 11 to 13.3), and the difference was found statistically significant (P<0.001). When the preoperative and postoperative mean 6mWT results were compared, diastolic blood pressure increased from 70 to 80 mmHg (P=0.031), heart rate increased from 83.5±13.2 to 90.1±12.5 bpm (P=0.017), dyspnea rate decreased from 1 to 0 (P=0.002), and fatigue scores reduced from 2 to 1 (P=0.003). Evaluation on spirometry findings revealed that FIF50% (maximum inspiratory flow at 50% of forced vital capacity [FVC]) scores and peak expiratory flow (PEF) values improved significantly after surgery. Septoplasty improves the nasal breathing pattern. While reducing FEF50% (maximum expiratory flow at 50% of FVC)/FIF50%, it increases PEF and FIF50% values. In addition, as shown by 6mWT, exercise capacity improves following surgery. Postoperative NOSE and SNOT22 scores reduced markedly compared to preoperative values (P<0.001).
  
  
  CONCLUSIONS
  These findings suggest that nasal septal surgery has a positive effect on pulmonary functions, and this can be an important clue for the relationship of lung disorders and nasal obstruction.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Tuzuner
authors.affiliation: Department of Pulmonology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Gulden
authors.initials: G
authors.lastname: Bilgin
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Demirci
authors.affiliation: Department of Pulmonology, Ministry of Health, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Gulbahar Darilmaz
authors.initials: GD
authors.lastname: Yuce
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Cemile
authors.initials: C
authors.lastname: Acikgoz
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Ethem Erdal
authors.initials: EE
authors.lastname: Samim
keywords: Exercise Test; Nasal Obstruction; Questionnaires; Spirometry