Quality of life assessment in nasal airway obstruction.

OBJECTIVES/HYPOTHESIS: Quality of life (QOL) assessment of patients with nasal obstruction has not been well studied. The objectives of the study were to determine the QOL of patients with nasal obstruction, to identify baseline variables predictive of patients' QOL, and to examine the relationship of QOL scores with patient assessment of nasal obstruction.

STUDY DESIGN: Preliminary, cross-sectional study of a larger, prospective investigation.

METHODS: Forty individuals met the criteria for inclusion. Participants were required to have a surgically treatable diagnosis of septal deviation, nasal valve collapse, and/or turbinate hypertrophy. Quality of life assessment was performed using the Rhinoconjunctivitis Quality of Life Questionnaire and the Rhinosinusitis Disability Index. Demographic data, along with patient assessment of nasal obstruction with a visual analogue scale, were recorded.

RESULTS: Both instruments demonstrated good inter-item correlation as measured by Cronbach's alpha. Demographic variables, previous nasal surgeries, and comorbid conditions were not significantly correlated with QOL scores with either instrument. Correlations between visual analogue scale scores and the Rhinoconjunctivitis Quality of Life Questionnaire "sleep" (correlation coefficient [r] = 0.35, P =.02) and "nasal symptom" (r = 0.36, P =.02) domains demonstrated a trend toward significance. Patients with nasal valve collapse reported higher visual analogue scale scores for nasal obstruction compared with those with septal deviation alone (P <.01).

CONCLUSIONS: Patients with nasal valve collapse demonstrated greater perception of nasal obstruction than those with septal deviation alone. The Rhinoconjunctivitis Quality of Life Questionnaire appears to be a more sensitive instrument than the Rhinosinusitis Disability Index for patients with nasal obstruction. However, existing measures may lack sensitivity in estimating the QOL of patients with nasal obstruction. A disease-specific instrument for nasal obstruction may be necessary to further evaluate this disease process.