Literature DB >> 30452512

Health Impairment From Nasal Airway Obstruction and Changes in Health Utility Values From Septorhinoplasty.

Richard Tjahjono1,2, Raquel Alvarado1, Larry Kalish1,2, Raymond Sacks1,2,3, Raewyn Campbell1,2, George Marcells1, Carolyn Orgain1, Richard John Harvey1,3.   

Abstract

IMPORTANCE: The association of nasal airway obstruction with health is significant, and the health care resources utilized in open septorhinoplasty need to be included in health economic analyses.
OBJECTIVES: To describe the association of nasal airway obstruction and subsequent open septorhinoplasty with patient health. DESIGN, SETTING, AND PARTICIPANTS: A prospective case series study was conducted from September 30, 2009, to October 29, 2015, at 2 tertiary rhinologic centers in Sydney, Australia, among 144 consecutive adult patients (age, ≥18 years) with nasal airway obstruction from septal and nasal valve disorders.
INTERVENTIONS: Open septorhinoplasty. MAIN OUTCOMES AND MEASURES: Patients were assessed before undergoing open septorhinoplasty and then 6 months after the procedure. Health utility values (HUVs) were derived from the 36-Item Short Form Health Survey. Nasal obstruction severity was also measured using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and the Sino-Nasal Outcome Test 22 questionnaires.
RESULTS: A total of 144 patients (85 women and 59 men; mean [SD] age, 38 [13] years) were assessed. The baseline mean (SD) HUV for patients in this study was 0.72 (0.09), which was below the weighted mean (SD) Australian norm of 0.81 (0.22). After open septorhinoplasty, the mean (SD) HUV improved to 0.78 (0.12) (P < .001). Improvements in HUV were associated with changes in disease-specific patient-reported outcome measures, including Nasal Obstruction Symptom Evaluation scores (r = -0.48; P = .01) and Sino-Nasal Outcome Test 22 scores (r = -0.68; P = .01). CONCLUSIONS AND RELEVANCE: Patients with nasal airway obstruction reported baseline HUVs that were lower than the Australian norm and similar to those in individuals with chronic diseases with significant health expenditure. There was a clinically and statistically significant improvement in HUVs after open septorhinoplasty that was associated with a reduction in Nasal Obstruction Symptom Evaluation and Sino-Nasal Outcome Test 22 scores. Outcomes from this study may be used for health economic analyses of the benefit associated with open septorhinoplasty. LEVEL OF EVIDENCE: 4.

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Year:  2019        PMID: 30452512      PMCID: PMC6439790          DOI: 10.1001/jamafacial.2018.1368

Source DB:  PubMed          Journal:  JAMA Facial Plast Surg        ISSN: 2168-6076            Impact factor:   4.611


  43 in total

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