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Facial Plast Surg 2021; 37(05): 625-631
DOI: 10.1055/s-0041-1725162
Original Research

The Evidence Base for the Benefits of Functional Septorhinoplasty and its Future Post COVID-19

Samit N. Unadkat 
1   Department of Rhinology and Facial Plastic Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
,
Alfonso Luca Pendolino
1   Department of Rhinology and Facial Plastic Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
2   Ear Institute, University College London, United Kingdom
,
Deborah Auer
3   Department of Otolaryngology, Charing Cross Hospital, London, United Kingdom
,
Sadie Khwaja
4   Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
,
Premjit S. Randhawa
1   Department of Rhinology and Facial Plastic Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
,
Peter J. Andrews
1   Department of Rhinology and Facial Plastic Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
2   Ear Institute, University College London, United Kingdom
,
Hesham A. Saleh
3   Department of Otolaryngology, Charing Cross Hospital, London, United Kingdom
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Abstract

Ever since the introduction of the concept of Procedures of Limited Clinical Value (PoLCV), procedures such as functional septorhinoplasty have been subject to additional funding restrictions within the British National Health Service. Recent publications have suggested that 10% of Clinical Commissioning Groups in the United Kingdom no longer fund septorhinoplasty surgery irrespective of the indications, including congenital malformations or post-trauma, and despite the strong evidence available in the literature in treating a range of health conditions. Thus, inequity exists across the country. At present functional septorhinoplasty surgery is frequently but incorrectly grouped together with aesthetic rhinoplasty, both of which are deemed to be cosmetic interventions. Moreover, as we exit the peak of the current coronavirus disease 2019 (COVID-19) pandemic, procedures deemed to be of lower clinical priority will potentially be at risk throughout Europe. The purpose of this review is twofold; the first is to put forward the evidence to commissioners in favor of functional septorhinoplasty surgery on patient well-being and mental health; the second is to demonstrate why functional septorhinoplasty surgery is a distinct procedure from aesthetic rhinoplasty and why it ought not to be classified as a procedure of limited clinical value.

Keywords

evidence-based medicine - nasal obstruction - nasal septum - rhinoplasty - sleep apnea - obstructive

Authors' Contributions

S.N.U. contributed toward the concept of paper, drafting of manuscript. A.L.P. contributed toward the literature review and review of manuscript. D.A. edited section on psychology in functional septorhinoplasty. S.K. edited sections on why nasal obstruction needs treating and what are the health benefits of functional septorhinoplasty. P.S.R. prepared the concept of paper and did the final manuscript review. P.J.A. edited the section on methods used to assess nasal obstruction. H.A.S. did the supervision and drafting of manuscript.




Publication History

Article published online:
06 March 2021

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