Patient-Reported Outcome Measures Including Nasal Breathing Improvement After Functional Rhinoplasty Using Endonasal Septal Extension Grafting

Goldfarb JM, Taylor CM, Barrera JE.

What this paper says

In 34 patients with a deviated caudal septum, closed rhinoplasty with a septal extension graft plus septoplasty and turbinate reduction cut NOSE scores by 49.4 points and SNOT-22 by 24.2 with no complications.

Overview

Barrera's group reviewed patients with nasal obstruction who had septoplasty, turbinoplasty and an endonasal septal extension graft, measuring breathing (NOSE, SNOT-22, SCHNOS) and sleepiness (Epworth) before and after. It is described as a pilot study.

Sections of note

34 patients; median age 38.3 (range 17-58); 52.9% male.
All had septoplasty and turbinate reduction as well.
Mean follow-up 126.6 days (range 28-573).
NOSE fell from 71.5 by 49.4 points; SNOT-22 from 35.4 by 24.2; Epworth from 6.7 by 3.4 (all p < 0.001).
SCHNOS total fell by 28.0, functional by 44.5; cosmetic changed by 17.1 (p < 0.001). No complications.

What it means for a patient

A crooked front septum can be corrected and the tip supported through a closed approach with large gains in breathing scores.
Follow-up averaged about four months, so long-term durability is not shown.
Every patient also had turbinate and septal surgery, so the graft's individual contribution cannot be separated.

Why this paper matters

It supports the septal extension graft as a functional tool through the closed approach. Limits: 34 patients, retrospective, short and variable follow-up, combined procedures.

Terms

Septal extension graft (SEG): cartilage attached to the septum to lengthen and stabilise it.
Caudal septum: the front edge of the septum.
Turbinoplasty: reducing the turbinates, the shelves of tissue inside the nose that can swell and block airflow.
Epworth Sleepiness Scale: a daytime sleepiness questionnaire.
NOSE / SNOT-22 / SCHNOS: validated nasal symptom questionnaires; lower is better.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“To measure the change perceived by patients after endonasal rhinoplasty using a, septal extension graft (SEG), as measured by patient-reported outcome measures (PROMs). Methods: A retrospective review of patients with nasal obstruction underwent septoplasty, turbinoplasty, and SEG. PROMs were assessed to compare…”

Excerpt; the full abstract is on PubMed.