title: Evaluating the Effect of Spreader Grafting on Nasal Obstruction Using the NOSE Scale.
abstract: OBJECTIVE
  The Nasal Obstruction Symptom Evaluation (NOSE) scale has been used to demonstrate that surgery improves nasal obstruction, but no study has directly compared surgical techniques. We performed a retrospective study comparing NOSE scores to quantify the effects of spreader grafting on postoperative nasal patency.
  
  
  METHODS
  We compared NOSE scores of patients who underwent septoturbinoplasty to open septorhinoplasty with spreader graft placement. We used a paired samples t test to evaluate the difference between pre- and postoperative NOSE scores and the improvement in NOSE score between patients who underwent septoturbinoplasty and those who underwent open septorhinoplasty with spreader graft placement.
  
  
  RESULTS
  Surgery reduced NOSE scores by an average of 46 points ( P < .001). The mean differences in NOSE score across all time points after septoturbinoplasty and septorhinoplasty with spreader graft placement was 40 and 49, respectively. The mean improvement in NOSE score at the second follow-up appointment was 27 for patients who had undergone septoturbinoplasty and 51 for patients who had undergone septorhinoplasty with spreader graft placement ( P = .04).
  
  
  CONCLUSIONS
  This is the largest study quantifying the effect of spreader grafting. Greater improvement was observed from septorhinoplasty with spreader graft placement than septoturbinoplasty, and this improvement persisted over time.
authors.affiliation: 1 Department of Otolaryngology, Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Aurora G
authors.initials: AG
authors.lastname: Standlee
authors.affiliation: 1 Department of Otolaryngology, Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: Marc H
authors.initials: MH
authors.lastname: Hohman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000150:complications* / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D063189:Symptom Assessment; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery*; D055815:Young Adult
keywords: NOSE scale; rhinoplasty; septoturbinoplasty; spreader grafting