Septoplasty techniques- conventional versus endoscopic: our experience

Abstract

<p class="abstract"><strong>Background:</strong> Deviated nasal septum is one of the most common disorders in human beings, which may lead to symptoms of nasal obstruction, headache, epistaxis, hyposmia, and post nasal drip. DNS correction may also be required to gain access during intranasal procedures like endoscopic sinus surgery, endoscopic dacryocystor-hinostomy and skull base surgery. The technique of septoplasty has evolved over the decades with a tendency towards more conservative and precise surgery. Over the last few decades endoscopic septoplasty has become increasingly popular.</p><p class="abstract"><strong>Methods:</strong> It was a cross-sectional comparative study done to compare the efficacy of endoscopic septoplasty with conventional septoplasty, conducted at a tertiary care centre over a period of 3 years. Records of 100 patients of nose and PNS disorders with DNS who were operated either by conventional or by endoscopic technique were studied. The patients were studied for the improvement in their symptoms, anatomical correction and intra-operative/post-operative complications. </p><p class="abstract"><strong>Results:</strong> Endoscopic septoplasty group patients showed better symptomatic relief, lesser incidence of residual anterior /posterior deviation and persistent spur and less complications as compared to the conventional septoplasty group.</p><p><strong>Conclusions:</strong> In our study we found more clientele satisfaction and lesser rate of complications in endoscopic septoplasty group. We recommend all ENT specialists to be trained in nasal endoscopic septoplasty technique as it offers many advantages such as more precision in post nasal spurs with less flap tears, it can be tailor made according to the disease and can be combined with various endoscopic surgeries.</p>

Endoscopic Septoplasty without Nasal Packing: An Experience in a Tertiary Hospital

“…These findings were consistent with the study of Singla K et al [19]. The improvement in symptoms of the patients were 90% in nasal obstruction, 88% in hyposmia, 85% in post nasal drip, 90% in epistaxis and 100% in headache which was similar to the studies described by Rajguru R et al and Singla K et al [18,19]. The complications in this study were haemorrhage 1(1.5%), synechia 2 (3.07%), mucosal tear 5 (7.69%), haematoma 1(1.5%) and persistent DNS 5 (7.69%) which were similar to studies done by Hwang et al; Chung et al; Eski E and Yilmaz but haemorrhage was higher in study by Eski E [6,7,13].…”

“…In our study the sex distribution of male and female was 1.3:1.0 which was similar to that of Mandour ZM16 The age group of the patients in this study were maximum in 2nd to 3rd decade of life which was comparable to a study done by Mandour ZM; Dodia MN et al [16,17]. The most common complaints presented by patients in this study was nasal obstruction 51(78.46%) which was similar to the studies done by Rajguru R et al and Singla K et al [18,19]. It was followed by post-nasal drip 20(30.76%), hyposmia 17 (26.15%), headache 15 (23.07%) and epistaxis 10 (15.38%) which was similar to study done by Mandour ZM; Gupta M and Motwani G but headache was the second common complaint in Gupta M and Motwani's study [16,20].…”

Comparison of post-operative outcomes and difficulties of endoscopic with conventional septoplasty with its advantages and complication: A comparative study at tertiary care center

“…Similar results were obtained by Park et al, who conducted a comparative study between endoscopic and classical septorhinoplasty on 44 patients in whom the patient satisfaction and complication percentage were 87.5% and 0% in endoscopic group and, 71.4% and 14.3% in classical septorhinoplasty group [10]. The results obtained from the present study were also similar to a study conducted by Rajguru et al, on 100 patients to compare the efficacy of endoscopic septoplasty with conventional septoplasty in which the complication rate was found to be less in the endoscopic septoplasty group [11]. Gray (1965), Pease (1969), Jazbi (1974) have extensively studied the factors responsible for deviated nasal septum in early childhood and they believed that prenatal traumatic factors may produce anterior septal dislocation and it becomes pronounced as age advances [12][13][14].…”

Key Considerations in Practices and Principles of Endoscopic Septoplasty: Lessons, Mistakes and Future

“…NOSE score has emerged as a frequently used health related quality of life instrument specific to nasal obstruction in surgical patient 20 . In our study, there was a significant subjective improvement in the NOSE score postoperatively and the decline was 96.26%.Singh A et al 12 Several studies concluded that ES is beneficial in regards to illumination, avoiding unnecessary tissue handling, flap tear, septal perforations and hematoma 1,8,11 . We found that there are reduced chances of synechiae formation and flap tear which may be due to the limited extent of flap dissection along with limited manipulation and resection of septal framework.…”

“…They have evolved from primitive intrusive procedures to procedures with better outcome and fewer complications. Over the decades, technique has changed from forcible fractures and splinting to submucous resection, classical septoplasty to endoscopic septoplasty (ES) 1,2 .…”