DISSERTATION. Seventy percent of patients who have had surgery for chronic nasal congestion are satisfied. But the surgery is performed significantly more often on male patients, according to a new dissertation from the University of Gothenburg carried out at Sahlgrenska University Hospital. “It’s possible that women don’t seek out help for their nasal congestion to the same extent as men,” says Johan Hellgren, professor and chief physician.
Issues with nasal congestion can impact quality of life in various ways, such as night-time snoring, disruptions to sleep and subsequent fatigue. In turn, this impacts quality of life during leisure time and the ability to manage school and work. But the problem can often be corrected through septum surgery, or septoplasty.
“The surgery improves breathing and involves correcting the nasal septum to create more space on the tight side. In conjunction with septum surgery, we also operate fairly often on the nasal concha to create extra space for nasal breathing,” says Lars Pedersen, chief physician in the ear, nose and throat department, who defended his dissertation in February 2023.
The dissertation is based on studies carried out at Sahlgrenska University Hospital. The studies included 6,000 patients from all over Sweden with data from the National Quality Registries, which has followed these patients since 1997. The purpose of the dissertation is to try to find crucial factors for better results after surgery.
“These are usually middle-aged patients, and you can imagine that nasal congestion impacts both the extent and quality of performance. Improved nasal breathing can have a positive impact on night-time sleep, day-time productivity, and oxygenation with physical activity,” says Johan Hellgren, chief physician at the Ear, Nose and Throat department at Sahlgrenska University Hospital and professor at the University of Gothenburg.
The study shows that 70% of patients who have had the surgery were satisfied with the results. The study findings also show that advanced age at the time of surgery and no unplanned return visits in the first month after surgery correlate with good septum surgery outcome.
“Maybe the most important finding is that you should stick to performing this surgery on patients with a certain degree of nasal congestion, moderate or severe, because they are more satisfied after surgery,” says Johan Hellgren.
A deviated septum can be congenital or caused by trauma to the nose. The dissertation shows that men are overrepresented among patients who undergo septum surgery in Sweden. Two out of three individuals who undergo this surgery are men. The study found no differences between men and women when it came to age or BMI before the surgery. Nor were any differences detected between women and men in the results after the surgery.
“We don’t know why more men than women undergo this surgery. It’s possible that women don’t seek out help for their nasal congestion to the same extent as men. A recurring theory is that men experience more trauma to the face and nose and therefore need surgery to a greater extent. Another interesting theory that we’re discussing is that women’s airways are protected by hormones up until menopause, which is evident in the increase in sleep apnea among post-menopausal women. But this is just a theory and has not been established,” says Johan Hellgren.
BY: SAHLGRENSKA UNIVERSITY HOSPITAL
