Septoplasty: is it possible to identify potential “predictors” of surgical success?

Septoplasty is one of the most frequent surgical procedures performed by head and neck surgeons. Despite surgical correction, some patients are not satisfied with their postoperative outcomes. Only a few papers report data on the long-term quality of life of patients after septoplasty, and none over 36 months. This follow up study on 68 surgical procedures aims to evaluate the differences between short term and long-term quality of life after septoplasty using a disease specific quality of life questionnaire, the NOSE, and a general health status questionnaire, the SF-36. We found a statistically significant decrease of the total long-term SF-36 scores, but we did not find changes of the NOSE scores compared with the short-term scores. These results indicated that patients perceived a worsening of their quality of life after more than 36 months following septoplasty, even in the absence of specific nasal symptoms. We could speculate that the preoperative general health performance was erroneously attributed to specific nasal symptoms, probably incorrectly emphasized or that patients did not correctly remember the preoperative clinical status. This research pointed out the importance of patients’ selection and of a thorough evaluation of their preoperative expectations before surgical planning.

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“…However, our study, demonstrated that QoL rate after septoplasty decreased with time, even after 55 months [ 3 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Septoplasty represents one of the most frequent surgical procedures performed by head and neck surgeons. However, despite surgical correction, some patients are not satisfied with their postoperative outcomes with consequent impairment of QoL and medicolegal problems [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Why Does General QoL Tend to Worsen Over Time Following Septoplasty Even in the Absence of Worsening Nasal Symptoms?

Cantone

Iengo

2020

Indian J Otolaryngol Head Neck Surg

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“…Moreover, these procedures aim to expand the nasal valve region in 2 dimensions. 18,19 Therefore, golden ratio can provide us with a useful perspective to evaluate the pathological anatomical status of the nose. The golden ratios of individuals with normal nasal anatomy and normal nasal functions have been evaluated in this study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Golden Ratio in Nasal Conchae for Surgical Anatomy

et al. 2019

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Purpose: The golden ratio is reached by the fractal model of the number sequence which is known as the “Fibonacci series” and has a convergent ratio of approximately 1.618 between 2 consecutive Fibonacci numbers. Golden ratio relationships have been shown in several plants in the nature and several organs and structures in the human body. The conchae, which form an important part of the nasal valve, have a special geometric significant in terms of providing turbulence to the laminar airflow that passes to the nasal cavity. Methods: This study made golden ratio calculations on 34 adults aged 20 to 45 years over computed tomography (CT) images. Totally, 34 volunteers (male, n = 18 and female, n = 16) with no nasal pathologies participated in the study. Using Adobe Photoshop, golden ratio calculations were made by applying the Fibonacci spiral on the images that best showed the conchae and meatuses on the CT images. Results: The intersection points of the spiral that was projected on the inferior and middle nasal concha were determined as S0, S1, S2, S3, and S4. The distances of S0-S1, S1-S2, S2-S3, and S3-S4 were measured. The concha measurements of the women showed significantly similar values to the golden ratio constant of ∼1.618 in the RS3/S4 and LS3/S4 measurements. Conclusion: We found that the S3/S4 region that captured the golden ratio in our study corresponds to the base part of the inferior nasal concha, and its place of spiraling in the nasal cavity is observed to have an important role in creating vortices.

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“…Nasal obstruction is associated with anatomical as well as mucosal conditions. The most frequent anatomical cause is a deviated nasal septum, which can be accompanied by hypertrophy of the turbinate contralateral to the deviation 2 , 3 . Although the actual prevalence of nasal septal deviation is not known, one study reported a prevalence of 90% 4 .…”

Section: Introductionmentioning

confidence: 99%

A clinical and histopathological comparison of saline, adrenaline and 2-mercaptoethanesulfonate (MESNA) in mucoperichondrial elevation: which is superior?

Çınar¹,

Yiğit²,

Turanoğlu³

et al. 2021

Acta Otorhinolaryngol Ital

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SUMMARY Objective To determine whether submucosal mesna ( 2-mercaptoethane sodium sulfonate) infiltration is superior to normal saline or adrenaline + lidocaine in mucoperichondrial hydrodissection. Methods Twenty-one rabbits were administered adrenaline + lidocaine, saline or mesna. Bilateral septal mucoperichondrial flap elevations were performed following submucosal infiltration. The intraoperative bleeding amount, operation time, accessibility of the surgical plane, field quality and degree of mucoperichondrial injury were recorded. The three groups were compared histopathologically. Results The amount of bleeding and duration of the operation were significantly higher and the accessibility of the surgical plane score was significantly lower in the saline group vs. the other groups (p < 0.05). The mucosal damage rate was significantly higher in the saline group compared with adrenaline + lidocaine (p < 0.05). The surgical field quality was significantly lower in the saline group compared with adrenaline + lidocaine (p < 0.05). The accessibility of the correct surgical plane score was significantly lower in the saline group compared with the adrenaline + lidocaine and mesna groups (p < 0.05). The amount of bleeding, duration of operation, surgical field quality and accessibility of the surgical plane did not differ significantly between the adrenaline + lidocaine and mesna groups (p > 0.05). The pericondrium thickness was significantly lower in the saline group than the other groups. Cartilage thickness was significantly higher in the saline group compared with the mesna group (p > 0.05). Conclusion Use of mesna instead of normal saline or adrenaline + lidocaine in septoplasty was not more advantageous in terms of intraoperative parameters. The adrenaline + lidocaine group was superior to normal saline for all intraoperative parameters. In conclusion, the use of adrenaline may be more advantageous in facilitating septal mucoperichondrium elevation due to its widespread use, low cost and superiority to physiological saline.

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Septoplasty: is it possible to identify potential “predictors” of surgical success?

Cited by 14 publications

References 29 publications

Why Does General QoL Tend to Worsen Over Time Following Septoplasty Even in the Absence of Worsening Nasal Symptoms?

Why Does General QoL Tend to Worsen Over Time Following Septoplasty Even in the Absence of Worsening Nasal Symptoms?

Evaluation of the Golden Ratio in Nasal Conchae for Surgical Anatomy

A clinical and histopathological comparison of saline, adrenaline and 2-mercaptoethanesulfonate (MESNA) in mucoperichondrial elevation: which is superior?

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