According to the Stanford University School of Medicine, cases of documented nasal obstruction – like a deviated septum – are better treated by surgery rather than corticosteroid nasal sprays. Moreover, surgery is more cost-effective in the long run.
(Read more about deviated septum surgery.)
Lead author Sam P. Most, M.D. of Stanford found that health insurance companies usually first require a course of nasal steroid sprays before surgically treating nasal obstruction.
According to Dr. Most, nasal sprays usually treat allergic diseases in the nose.
(Learn about the nasal obstruction surgery, turbinate reduction surgery.)
But the sprays don’t help blocking conditions in the nose like a deviated septum or a condition known as nasal valve stenosis, in which important anatomy inside the nose collapses and blocks airflow.
(See some face and neck lift before & after pictures.)
Dr. Most and colleagues studied 179 men and women in Stanford’s facial plastic and reconstructive surgery clinic, all of whom had some nasal blockages.
Researchers then gave the subjects a quality-of-life exam, asking if they had:
- Nasal congestion and stuffiness
- Nasal blockages
- Trouble breathing or sleeping
- Getting enough air during workouts
The study subjects then marked if the problem was very mild, moderate, fairly bad, severe or didn’t exist at all.
Results? Of 179 subjects, 138 (77.1 %) checked severe to extreme nasal obstruction while 41 others (22.9%) said their symptoms were mild to moderate.
Trying nasal sprays, 171 had no improvement and were offered surgery; 111 patients opted in and then had nasal surgery to clear a nasal obstruction.
The quality of life scores soared after nasal obstruction surgery, but not for the spray patients.
“So medical care is being dictated by insurance companies instead of medical evidence,” writes Dr. Most in a recent issue of JAMA Facial Plastic Surgery, a professional magazine for cosmetic plastic surgeons.
The study also found that nasal obstruction surgery — while costing more at the start — was more cost-effective at the five-year point due to improved quality of life scores.
Added Dr. Most: “Insurance companies only figure how much they spend on each patient up front. So any patient denied surgery is a plus for them.”
Dr. Most and colleagues want more facial plastic surgeons to do additional testing which may challenge insurer rules and regulations that may be “roadblocks” to more effective surgical treatments.
(Read the JAMA Facial Plastic Surgery article.)