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. 2019 Mar 1;21(2):146-151.
doi: 10.1001/jamafacial.2018.1368.

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

Richard Tjahjono  1   2 , Raquel Alvarado  1 , Larry Kalish  1   2 , Raymond Sacks  1   2   3 , Raewyn Campbell  1   2 , George Marcells  1 , Carolyn Orgain  1 , Richard John Harvey  1   3
Affiliations

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

Richard Tjahjono et al. JAMA Facial Plast Surg. .

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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Conflict of interest statement

Conflict of Interest Disclosures: Dr Kalish reported serving on the speakers’ bureau for Care Pharmaceuticals and Mylan Pharmaceuticals. Dr Harvey reported serving as a consultant for Medtronic, Olympus, and NeilMed Pharmaceuticals and serving on the speakers’ bureau for GlaxoSmithKline, Seqirus, and AstraZeneca. No other conflicts were reported.

Figures

Figure.
Figure.. Comparison of Short Form-6D–Derived Health Utility Values Between Different Chronic Disease States in Australia
aThe disease burden of nasal airway obstruction was significant.
See this image and copyright information in PMC

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