Septoplasty: Defining a desirable clinical outcome according to baseline symptom scores

Rolf Haye ^1,2* Liv Kari Døsen ¹ Magnus Tarangen ¹ Caryl Gay ¹ Are Hugo Pripp ² Olga Shiryaeva ¹

• ¹ Lovisenberg Diakonale Sykehus, Oslo, Norway
• ² Oslo University Hospital, Oslo, Nordland, Norway

Objective. Results of septoplasty are usually measured with assessments of symptom severity immediately before and some months after surgery. Global ratings of surgical outcome can be used to clinically evaluate changes in symptom severity. Important to the patient are ratings such as "satisfied", "successful" or "much improved". We like to refer to such ratings as the Desirable Clinically Important Difference (DCID). Global clinical ratings have been established for whole cohorts but not for individual baseline scores. Our aim was to investigate how the DCID relates to baseline ratings of nasal obstruction, which can then be used to assess individual results.preoperatively and 6 months postoperatively. A global rating of outcome (completely, much, or somewhat improved, unchanged, or worse) served as the anchor postoperatively. The Conclusion. A 49% improvement from baseline would be a clinical success for a patient with moderately-obstructed nasal breathing, whereas 61% improvement is needed with very severe obstruction. The relative DCID can be a guide to assess improvement following septoplasty according to baseline scores of nasal obstruction and in planning of surgery.