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.