Assessment of Quality of Life After Endoscopic Septoplasty in Adults with Deviated Nasal Septum

Vemulapalli geetika lakshmi

Keywords: Deviated nasal septum, Endoscopic septoplasty, Quality of life, NOSE scale, SNOT- 22, PROMs

Background: Deviated nasal septum (DNS) is a common anatomical abnormality causing nasal obstruction, sleep disturbance, recurrent sinusitis, and impaired quality of life (QoL). Septoplasty is the standard surgical treatment, and in recent decades, endoscopic techniques have been introduced to enhance precision and reduce complications. Evaluating the impact of endoscopic septoplasty on QoL is crucial for guiding clinical decision-making, particularly in Indian healthcare settings where routine use of patient-reported outcome measures (PROMs) is limited. Aim: To systematically assess the impact of endoscopic septoplasty on QoL in adults with DNS and to compare its effectiveness and safety with conventional septoplasty. Methods: A systematic literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2025. Randomized controlled trials (RCTs), cohort studies, and meta-analyses that reported QoL outcomes using validated PROMs-- such as the Nasal Obstruction Symptom Evaluation (NOSE), Sinonasal Outcome Test-22 (SNOT- 22), and Glasgow Benefit Inventory (GBI)--were included. Data on demographics, baseline scores, postoperative changes at 1, 3, and 6 months, and complication rates were extracted and synthesized narratively. Results: Patients undergoing endoscopic septoplasty demonstrated substantial improvement in QoL, with mean NOSE reductions of approximately -48 points at six months and SNOT-22 improvements of 18-20 points, both exceeding minimal clinically important difference thresholds. Symptom relief was evident at one month and remained stable up to 12 months. Compared with conventional septoplasty, endoscopic techniques showed comparable PROM gains but with significantly fewer complications, including reduced synechiae and hemorrhage. Predictors of poorer outcomes included allergic rhinitis, psychological distress, and nasal valve dysfunction.Conclusion: Endoscopic septoplasty is a safe, effective, and patient-centered intervention that provides rapid and sustained QoL improvements in adults with DNS. Incorporation of PROMs such as NOSE and SNOT-22 into routine Indian practice is recommended to standardize outcome measurement. Larger multicenter Indian RCTs with long-term follow-up are warranted to strengthen evidence- based practice.

Volume 13 Issue 8, August-2025

Pages : g399-g418