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    Does septoplasty improve the quality of life in children?
    (Elsevier, 2014) Yılmaz, Mahmut Sinan; Güven, Mehmet; Akidil, Öznur; Kayabaşoğlu, Gürkan; Demir, Deniz; Mermer, Hasan; Demir, Deniz
    Objectives The aim of this study is to evaluate the outcomes of septoplasty and the effects of septoplasty on the quality of life and to determine postoperative patient satisfaction in children using nose obstruction symptom evaluation (NOSE) and visual analog scale (VAS). Methods Only pediatric patients who underwent septoplasty were included in the study. Patients who underwent adenoidectomy, endoscopic sinus surgery, or turbinate surgery in addition to septoplasty and total septal reconstruction with open technique septorhinoplasty were excluded from the study. Patients and their parents were inquired about their nasal obstruction symptoms using the NOSE scale before and 3 and 12 months following the surgery. VAS was used to analyze overall satisfaction of the patients and their parents on the outcomes of surgery, at the last follow-up examination 12 months after the surgery. Results Thirty-five patients with a mean age of 13.4 ± 2.8 (8–16) were included in the study. There was a very significant improvement in NOSE score at 3 months after septoplasty. The mean subjective satisfaction score measured with VAS at the 12th month postoperatively was 7.9 ± 2.1. Improvement in NOSE score was correlated with patient satisfaction. Conclusion Septoplasty is a very effective and satisfactory treatment for nasal obstruction caused by nasal septal deviation in children. The NOSE scale can be used for the evaluation of nasal obstruction symptoms.
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    Response to the letter to the editor regarding "does septoplasty improve the quality of life in children?"
    (Elsevier, 2014) Yılmaz, Mahmut Sinan; Güven, Mehmet; Akidil, Öznur; Kayabaşoğlu, Gürkan; Demir, Deniz; Mermer, Hasan; Demir, Deniz
    Dear Sir, We would like to thank Mr. D’Ascanio for his interest in our study entitled “Does septoplasty improve the quality of life in children?” and we appreciate his valuable comments. In response; absolute and relative indications have been described for performing septoplasty in children [1]. Absolute indications include septal hematoma, septal abscess, severe deformity secondary to acute nasal fracture, cleft lip nose and dermoid cyst. Nasal obstruction is one of the more common indications although it is thought as a relative indication. Derkay [2] reported that septoplasty should be considered in cases with an obvious nasal septal deformity causing severe impairment of daytime and nighttime breathing. We think that, there is a misunderstanding about our indications for performing septoplasty. We absolutely make decision for operation especially in cases with a history of obstructive sleep apnea syndrome and nasal obstruction during sleep. But this does not mean that we perform septoplasty only in these cases. We also perform surgery in cases with severe nasal septal deviation causing mouth breathing such as total obstruction in one nasal cavity. Therefore, we did not report polysomnography as a criteria in the “materials and methods”. The severity of septal deviation was determined by physical examination. No specific parameter is used for this determination in our clinic. As the author stated, the growth of septal cartilage ends at 5–6 years of age, while the vomer and perpendicular lamina grow until adolescence [3]. Therefore, when performing septoplasty in children, cartilaginous septum can be resected conservatively, but the bony part of the septum should not be removed. We agreed with the author. Hence, we performed the excision minimally in our cases.