The effects of disclosure of sequential rhinomanometry scores on post-septoplasty subjective scores of nasal obstruction: a randomised controlled trial Manestar, D.,* Braut, T.,* Kujundz ˇic ´, M.,* Malvic ´, G.,* Velepic ˇ, M.,* Donadic ´ Manestar, I.,   Matanic ´ Lender D. à & Starc ˇevic ´, R.* *Clinic of Otorhinolaryngology, Head and Neck Surgery,   Clinic of Ophthalmology, and à Clinic of Pulmology, University Hospital Rijeka, Rijeka, Croatia Accepted for publication 2 May 2012 Clin. Otolaryngol. 2012, 37, 176–180 Objective: We sought to evaluate the effects of awareness of rhinomanometric results on subjective sensation of nasal breathing in patients after septoplasty. Design: Prospective randomised study. Setting: Clinical Hospital Rijeka. Participants: A study of 60 patients (45 M, 15 F) who underwent septoplasty was performed at the ENT Clinic, Clinical Hospital Rijeka. The patients were randomised into two groups; group A was shown their rhinomanometry scores at 3 months postoperatively, while group B remained unaware of their rhinomanom- etry results. Main outcome measure: The assumption is that in the same settings patients aware of their rhinomanometric results have better performances of their Nasal Obstruc- tion Symptom Evaluation (NOSE) scale and thereby a better quality of life (QOL) after septoplasty. Results: The differences in rhinomanometric results and NOSE scale prior and after septoplasty were statistically significant (P < 0.001), all patients achieving better results after the operation. There was no statistically significant difference in resistance (F = 0.004; P = 0.948) and improvement of rhinomanometry results in postoperative measurements (F = 0.110; P = 0.896) between groups A and B. The symptoms measured by the NOSE scale were the same in both groups preoperatively and 1 month after septoplasty (F = 2.906; P = 0.094). Three months postoperatively in group A, the NOSE scale score was lower (M = 11.67; sd = 12.34) than in group B (M = 27.50; sd = 18.04). Conclusions: The results suggest that disclosing informa- tion to patients about their post-septoplasty rhinoma- nometry results may improve subjective nasal breathing, and thus improve their QOL. Nasal obstruction is one of the principal nasal symptoms of a heterogeneous group of diseases with different underlying aetiologies and pathophysiologies, including inflammation, trauma and structural abnormalities, such as nasal septal deviation (NDS). Objective evaluation of nasal obstruction caused by NDS is important, as this is a frequent condition with many possible therapeutic approaches. 1 It is not uncommon for the subjective feel- ing of impaired nasal breathing to be discordant with the endoscopic status of the nasal cavities. Therefore, objec- tive criteria are necessary for precise diagnosis and deter- mination of treatment options. 2 The gold-standard for the objective assessment of nasal patency is rhinomanometry, in which the nasal airway resistance is determined by measuring nasal airflow at different pressures. 3 Improvement of nasal breathing after septoplasty has been well reported in literature. 4,5 How- ever, it has also been demonstrated that improved nasal breathing sensation often poorly correlates with objective rhinomanometric results. 6 It is unknown to what extent patient knowledge of their rhinomanometry results is responsible for subjective improvement of nasal breathing, and to what extent this knowledge may have a placebo effect on the patient’s quality of life (QOL). This study investigated the impact Correspondence: D. Manestar, Clinic of Otorhinolaryngology, Head and Neck Surgery, University Hospital Rijeka, Kres ˇimirova 42, 51000 Rijeka, Croatia. Tel: +385 (0)98 800 791; Fax: +385 (0)51 624 372; e-mail: dubravko_manestar@net.hr ORIGINAL ARTICLE 176 Ó 2012 Blackwell Publishing Ltd • Clinical Otolaryngology 37, 176–180