The role of septoplasty in the management of nasal septum fracture: a randomized quality of life study

Fracture of the nasal septum is a common injury. Fracture reduction using Ash forceps is the standard treatment for non-severely comminuted cases. In this study, septoplasty was compared to Ash forceps reduction of nasal septum fractures with regard to the quality of life outcome of patient breathing. Thirty consecutive patients with non-comminuted septal fractures were divided randomly into two groups. In group I, fractures were managed by closed reduction (using Ash forceps), while in group II, fractures were managed by septoplasty surgery. Each patient completed a validated quality of life scale for breathing (Nasal Obstruction Symptom Evaluation, NOSE) preoperatively and at 3 months postoperative. In group I, the mean difference between postoperative and preoperative NOSE scores was −28.33 (range −40 to −15), while in group II the mean difference was −44.33 (range −70 to −30). There was a significant improvement in nasal breathing quality of life in group II compared with group I (t-test, P = 0.001). The results of this study showed a significant improvement in quality of life outcome with the use of septoplasty compared to closed reduction for acute septal fractures. Septoplasty could be recommended for patients with acute nasoseptal fractures to ensure better nasal breathing outcomes.