Negative impact of nasal septal perforation on quality of life: insights from 153 patients in a Spanish study.

OBJECTIVE

To evaluate the impact of nasal septal perforation (NSP) on sinonasal symptoms and quality of life (QoL) using patient-reported outcome measures.

METHODS

A prospective observational study was conducted between 2018 and 2024 in two referral centres. Clinical, demographic, symptom-related, and QoL data were collected for all included patients.

RESULTS

A total of 153 patients with NSP were included. The main aetiologies were intranasal cocaine abuse (n = 57; 37.3%), post-sinonasal surgery (n = 47; 30.7%), and rhinotillexomania (n = 31; 20.3%). The mean age was 47.8 years (SD 12.9; range 18.2-82.3), and 60.8% of patients were male. Anterior perforations were the most frequent location (n = 88; 57.5%). Mean perforation dimensions were 15.8 mm (SD 6.7) in height and 22.0 mm (SD 10.6) in length, with an estimated elliptic area of 312.9 mm² (SD 265.1; range 14.1-1272.3 mm²). The most frequent and severe symptoms reported on visual analogue scales were nasal obstruction (mean 58.3; SD 28.7), crusting (55.3; SD 34.9), and rhinorrhoea (44.8; SD 34.6). Quality of life was markedly impaired, with mean scores of 46.9 (SD 23.1) on the SNOT-22, 25.3 (SD 10.1) on the NOSE-Perf, and 24.1 (SD 10.1) on the SEPEQOL. The SF-36 physical and mental component summary scores were 45.0 (SD 10.5) and 40.5 (SD 14.2), respectively.

CONCLUSION

NSP is associated with a significant burden of sinonasal symptoms and a substantial impairment in quality of life. Patient-reported outcome measures demonstrate an impact on both physical and mental health domains, underscoring the importance of a comprehensive and multidisciplinary approach to the evaluation and management of patients with NSP.