Septoplasty waiting list validation using the nasal obstruction symptom evaluation (NOSE) score: A quality improvement project

Abstract

Background and aims

National Health Service waiting lists for some routine procedures are currently very long, and patients’ conditions may change during the wait, requiring reassessment before surgery can be offered. The objective of this study was to implement a septoplasty waiting list validation process incorporating the nasal obstruction symptom evaluation (NOSE) questionnaire to help streamline patient selection for septoplasty.

Methods and results

A telephone consultation incorporating the NOSE questionnaire was designed to validate the local septoplasty waiting list. NOSE scores were evaluated pre- and post-operatively. A total of 112 patients met the inclusion criteria. Thirty-three patients were removed from the waiting list on initial consultation, of whom the majority had a NOSE score ≤30 or had not trialled maximal medical management. In total, 86% of patients removed from the waiting list had not sought any further ENT input at the 4-year follow-up period. The mean NOSE score improved between pre- and post-operative evaluations (57.7 vs. 26.9, respectively, p < 0.0001). There was a strong correlation between higher pre-operative NOSE scores and improvement in NOSE scores post-operatively (r = 0.57293).

Conclusions

The NOSE score is an effective way to validate septoplasty waiting lists and assists in appropriate patient selection for septoplasty.