Objectives: The aim of the study was to compare rhinomanometry, acoustic rhinometry and subjective estimation of the nasal obstruction before and after septoplasty, and to evaluate the long-term results of septal surgery.

Design: Prospective long-term follow up, before and after septoplasty

Setting: University tertiary-care hospital, referral centre

Participants: The study included 30 adult patients who were operated on because of septal deviation.

Main outcome measures: Preoperatively, acoustic rhinometry and active anterior rhinomanometry were performed on each subject after decongestion of the nose. A visual analogue scale for unilateral nasal obstruction was filled in by the patients. The measurements were repeated both six months and ten years postoperatively.

Results: A significant change in acoustic values was found during the long-term follow up of ten years. The mean minimal cross-sectional area on the more obstructive side was 0.35 cm² preoperatively. Six months after operation it was 0.52 cm², and ten years after operation 0.68 cm². The mean resistance fell from preoperative 1.16 Pa/ml/s to 0.41 Pa/ml/s during the first six months, but rose again to 1.21 Pa/ml/s after ten years. No significant change was found between preoperative and postoperative values in VAS.

Conclusions: We found an increase in acoustic values, but an increase in nasal resistance in the long-term follow-up. Other factors than nasal area may have an impact on nasal resistance and the feeling of nasal obstruction. The small size on the sample interfered with the results.