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Clinical commissioning group criteria for rhinoplasty and septorhinoplasty in England: survey of current guidance

Published online by Cambridge University Press:  11 June 2018

E E Ross  and
S Anari
E E Ross*
Affiliation:
Department of ENT, Health Education West Midlands, Birmingham, UK
S Anari
Affiliation:
Department of ENT, Heart of England NHS Foundation Trust, Birmingham, UK
*
Address for correspondence: Miss Elizabeth E Ross, Department of ENT, Health Education West Midlands, St Chads Court, 213 Hagley Road, Birmingham B16 9RG, UK E-mail: [email protected]
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Abstract

Objective

Procedures of limited clinical value require pre-authorisation in the National Health Service, of which rhinoplasty and septorhinoplasty are two such operations. This study surveyed clinical commissioning groups within England to document the variable eligibility criteria for rhinoplasty and septorhinoplasty.

Methods

In February 2016, a letter was sent to 209 clinical commissioning groups requesting their rhinoplasty and septorhinoplasty commissioning criteria.

Results

A total of 200 clinical commissioning groups responded. Although 89.5 per cent allow septorhinoplasty in the presence of nasal obstruction, further criteria, such as documented health problems resulting from nasal blockage, severe functional impairment or a specific percentage of blockage, must be shown for septorhinoplasty to be authorised by most of the clinical commissioning groups.

Conclusion

There is great variation within individual clinical commissioning groups in England regarding the criteria for septorhinoplasty and rhinoplasty. Some criteria seem not to be clinically relevant and difficult to demonstrate. It is recommended that the guidelines are reviewed and harmonised nationally in future revisions.

Keywords

NoseRhinoplastySurveys And QuestionnairesDelivery Of Health CareEngland
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 591 - 595
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Miss E E Ross takes responsibility for the integrity of the content of the paper

References

1NHS Clinical Commissioners. About CCGs. In: https://www.nhscc.org/ccgs/ [29 April 2017]Google Scholar
2Audit Commission. Reducing spending on low clinical value treatments. In: http://webarchive.nationalarchives.gov.uk/20150421134146/http://archive.audit-commission.gov.uk/auditcommission/subwebs/publications/studies/studyPDF/3683.pdf [29 April 2017]Google Scholar
3Ishii, L, Roxbury, C, Godoy, A, Ishman, S, Ishii, M. Does nasal surgery improve OSA in patients with nasal obstruction and OSA? A meta-analysis. Otolaryngol Head Neck Surg 2015;153:326–33Google Scholar
4Wu, J, Zhao, G, Li, Y, Zang, H, Wang, T, Wang, D et al. Apnea-hypopnea index decreased significantly after nasal surgery for obstructive sleep apnea: a meta-analysis. Medicine (Baltimore) 2017;96:e6008Google Scholar
5National Institute of Health and Care Excellence. Clinical Knowledge Summary: Obstructive Sleep Apnoea. In: https://cks.nice.org.uk/obstructive-sleep-apnoea-syndrome#!backgroundsub:3 [29 April 2017]Google Scholar
6Stewart, M, Witsell, D, Smith, T, Weaver, E, Yueh, B, Hannley, M. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004;130:157–63Google Scholar
7Stewart, MG, Smith, TL, Weaver, EM, Witsell, DL, Yueh, B, Hannley, MT et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004;130:283–90Google Scholar
8Floyd, E, Ho, S, Patel, P, Rosenfeld, R, Gordin, E. Systematic review and meta-analysis of studies evaluating functional rhinoplasty outcomes with the NOSE score. Otolaryngol Head Neck Surg 2017;156:809–15Google Scholar