INTRODUCTİON
Nasal airway obstruction resulting from a septal deformity causing mouth
breathing, epistaxis, sinusitis, and even sleep apnea is observed in
one-third of the population.1 Therefore, septal
deformity constitutes the leading indication for septoplasty procedure.
Septoplasty entails identifying the area of septal deviation and
removing the deviated cartilage, allowing more space for airflow through
the nasal cavity.2 Although it is a relatively simple
procedure, it has its specific complications such as septal perforation,
external nasal deformity, and persistent preoperative symptoms due to
incomplete correction of the deviation.
Septal perforation is the most critical complication of septoplasty
procedure.3 The central pathophysiological phenomenon
in septal perforation is turbulent airflow. Disruption of normal laminar
airflow paves the way for septal perforation and crust formation at the
edges of the perforation site. This process starts the cascade of
interrelated symptoms such as dryness and whistling, which accompany
septal perforation. Dryness leads to more crusting, which prompts
bleeding, malodorous drainage, and obstruction. Infection follows the
stasis of secretions at the perforation site and contributes to the
pain. Whistling is a direct result of airflow through and around the
perforated area and completes the symptom profile, which significantly
diminishes the patient’s quality of life.4
It is suggested that the rate of complications after septoplasty may be
increased in patients smoking cigarettes regularly.5However, some studies showed controversial results regarding cigarette
smoking’s effects on the functional outcomes of
septoplasty.6 On the other hand, hookah smoking,
another way of tobacco consumption, is gaining popularity amid growing
evidence regarding its detrimental effects on the respiratory
system.3 Nevertheless, the impact of hookah smoking on
the complication rates and postoperative healing after septoplasty has
not been studied in the literature.
In this prospective study, we evaluated the effect of hookah and
cigarette smoking on the recovery period after septoplasty by giving
special consideration to healing times and the rates of septal
perforation.