08 Jan Medical Therapy In Patients With Severe Nasal Obstruction Likely To Fail
MedicalResearch.com Interview with:
Sam P. Most, M.D., F.A.C.S.
Professor, Departments of Otolaryngology-Head & Neck Surgery and Surgery (Division of Plastic Surgery, by courtesy)
Chief, Division of Facial Plastic & Reconstructive Surgery
Stanford University School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Most: Insurance companies often require patients to try a 6 or more week treatment with nasal steroids prior to allowing nasal surgery to proceed. This is true even in cases of physician-documented severe or extreme anatomic nasal obstruction that we know will not respond to medical therapy. We sought to examine this from a cost and quality-of-life perspective.
We found that while the up-front cost of surgery is obviously much higher than medical therapy, when viewed from an effect on improvement of quality of life (or lack thereof, in the case of medical therapy), the surgical therapy became more cost effective as years passed by.
Medical Research: What should clinicians and patients take away from your report?
Dr. Most: Medical therapy with nasal steroids in patients with severe or extreme anatomic nasal obstruction is likely to fail. We hope that this will provide evidence for insurers to allow physicians to more forward with surgical therapy in these cases with requiring nasal steroid therapy. This only delays treatment.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Most: We hope that other researchers will use this as a model for cost-effectiveness research in the field of nasal surgery.
Teti VP, Akdagli S, Most SP. Cost-effectiveness of Corticosteroid Nasal Spray vs Surgical Therapy in Patients With Severe to Extreme Anatomical Nasal Obstruction.JAMA Facial Plast Surg. Published online January 07, 2016. doi:10.1001/jamafacial.2015.2039.
Sam P. Most, M.D., F.A.C.S. (2016). Medical Therapy In Patients With Severe Nasal Obstruction Likely To Fail