Does Degree of Nasal Septal Deviation Measured with CT PNS have a Role in Management of Deviated Nasal Septum?

Background: Nasal Septal deviation is a frequently found entity in ENT OPD. The objective of the study was to describe the clinical presentations of deviated nasal septum, classify them according to the Mladina’s system and find out the relation of trauma with the type of septal deviation. Methods: One hundred fifty cases of septal deviation were classified according to Mladina’s classification, after thorough interview, nasal examination and nasal endoscopy. Data were analyzed with SPSS version 21, after tabulation. Chi-square test was applied as the test of significance. Results: Out of 150 cases of septal deviation, Male 82 (54.6%) outnumbered the female patients 68 (45.3%). Most of these patients were of second and third decade (20-40 years age group). The most common presenting complaint was that of nasal obstruction 121(80.6%), headache68 (45.3%) and nasal discharge52(34.6%). 78(52%) of patients revealed history of trauma. Type II 32 (21.3%) and Type V 31 (20.6%) were the commonest followed by Type III 24(16%). Conclusions: Nasal septal deviation is a common presentation in ENT OPD. Mladina’s classification found Type II and Type V to be quite common. Nasal obstruction, headache and rhinorrhea are frequent associated complaints. Nasal endoscopy is very important for the diagnosis, especially of posterior deflections.

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Endoscopic versus conventional septoplasty in the treatment of obstructive nasal septal deviation

Romanian Journal of Rhinology ◽

10.2478/rjr-2020-0026 ◽

2020 ◽

Vol 10 (40) ◽

pp. 123-131

Author(s):

Salah Nassrallah ◽

Mircea Cristian Neagos ◽

Gheorghe Muhlfay ◽

Adriana Neagos

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Upper Airway ◽

Subjective Assessment ◽

Septal Deviation ◽

Nasal Breathing ◽

Deviated Nasal Septum ◽

Nasal Septal Deviation ◽

Endoscopic Septoplasty ◽

Group I

AbstractBACKGROUND. Nasal septum deviations are disorders in which the nasal septum has an abnormal conformation that affects nasal breathing. Surgical correction of the deviated nasal septum, performed by various techniques, is one of the methods of repermeabilization of the upper airway. The aim of the present study was to evaluate the efficacy of endoscopic surgical treatment of the nasal septum deviation on the nasal obstruction, as well as to evaluate the frequency of postoperative complications compared to classical septoplasty.MATERIAL AND METHODS. A retrospective longitudinal study was performed on a group of 92 patients diagnosed with nasal septal deviation, between 2014-2018. 32 patients were excluded from the study after the exclusion criteria were applied. Two groups of 30 patients each were formed: Group I, endoscopic septoplasty was performed; Group II, the conventional septoplasty was used. An objective endoscopic and rhinomanometric evaluation, as well as a subjective assessment of symptoms (nasal obstruction, headache, posterior rhinorrhea, sneezing), was performed preoperatively and at 3 months postoperatively.RESULTS. The study showed better results (p<0.05) and fewer complications in endoscopic septoplasty compared to the traditional one, the endoscopic septoplasty providing better lighting and improved access, allowing a limited incision.CONCLUSION. Endoscopic septoplasty can be considered a reliable alternative to traditional techniques. It is essential to correctly identify the type of preoperative deformity in order to select the appropriate surgical strategy.

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Efficiency of modified Goldman’s technique in open pediatric septoplasty

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00074-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Omar Sabry ◽

Hazem Dewidar ◽

Mosaad abdel Aziz ◽

Amr Elemam ◽

Ahmed Nassar

Keyword(s):

Nasal Septum ◽

Pediatric Population ◽

Septal Deviation ◽

Nasal Resistance ◽

Deviated Nasal Septum ◽

Assessment Protocol ◽

Nose Scale ◽

Detailed Assessment

Abstract Background Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades. In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively. In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique. They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry. Results There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s. Conclusions Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.

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Septoplasty in Pediatric Population: A Ten Years' Experience

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i2.31379 ◽

2020 ◽

Vol 5 (2) ◽

pp. 1040-1044

Author(s):

Krishna Prasad Koirala

Keyword(s):

Nasal Septum ◽

Residual Disease ◽

Pediatric Population ◽

Adult Population ◽

Septal Deviation ◽

Facial Growth ◽

Nasal Breathing ◽

Deviated Nasal Septum ◽

Female Ratio ◽

Septal Surgery

Introduction: Septoplasty is a commonly performed surgical procedure worldwide in otorhinolaryngology. Septoplasty aims to correct the deviated nasal septum at the midline thereby opening the nasal airway in patients with long standing nasal obstruction secondary to septal deviation. Nasal breathing is important for proper facial growth and improvement of quality of life in children. Most surgeons are still reluctant to perform septoplasty in children. But septoplasty should be performed in children if there are severe breathing problems related to septal deviation. Objectives: The objectives of this study were to identify the incidence of children presenting with symptomatic nasal septal deviation and to analyze the early outcomes of septal surgery in children with regard to improvement in nasal symptoms, residual disease and need for revision surgery. Methodology: Children less than seventeen years of age who underwent septoplasty for symptomatic DNS from 1st January 2009 to 31st December 2018 were enrolled in the study. Patients having the follow up record of at least 6 months after surgery were included in the final analysis. Results: There were 37 male and 13 female children enrolled in the study. Male to female ratio was 2.84:1.Majority of children in the study were of 13 years (24%). Left sided DNS was seen in 28 children and right sided DNS in 22 children. Bleeding requiring re-packing, septal hematoma, recurrent DNS, synechia and septal perforation were the common complications, which were comparable to adult population. Conclusion: Early correction of the obstructed nose due to deviated nasal septum is essential to provide normal nasal breathing, relieve complications of mouth breathing and to promote normal craniofacial growth. Septoplasty can be performed in pediatric population with relatively good results without occurrence of nasal deformity and equal complications as that in adults.

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Extracorporeal Septoplasty for anterior septal deviation and deviated nose

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v13i2.30145 ◽

2020 ◽

Vol 13 (2) ◽

pp. 144-148

Author(s):

Brihaspati Sigdel

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Septal Deviation ◽

P Value ◽

Deviated Nasal Septum ◽

Deviated Nose ◽

Extracorporeal Septoplasty ◽

Airway Function ◽

The Aesthetic ◽

The Right

Background: Deviated nose and septum is challenging, which results in functional and cosmetic problems. It blocks the nose and makes person ugly. The classical septoplasty approach becomes unsuitable for such severe deviations. Extracorporeal septoplasty is a surgical technique for correcting a severely deviated nasal septum, which also corrects the aesthetic part of the nose. The objective of this study was to describe extracorporeal septoplasty for Deviated nose and anterior septal deviation. Methods: A prospective observational outcome study was done in patients with Deviated nose and anterior septal deviation who underwent extracorporeal septorhinoplasty. Preoperative and postoperative evaluation was performed using a photographs, computerized tomography (CT) scan, and Nasal obstruction symptoms evaluation scale. Results: A total of 38 consecutive patients were enrolled, out of which majority were male (24, 63.2%) with only 14 (36.8%) female. The ratio of male female was 1.7:1. All the subjects had deviated nasal septum. Among these, nose deviation was externally noticeable in 20 (52.6%) cases, whereas in remaining cases it was inconspicuous. There were 21(55.3%) patients where Nasal Septum was deviated to the right side followed by 17(44.7%) with left side deviation. There was a significant improvement in mean nasal obstruction symptoms evaluation postoperatively (71.2 versus 22.7 with p value equal to 0.01). According to the pre and postoperative photographs 17(44.7%) patients had good improvement, nine (23.6%) showed excellent improvement and the result was fair in six (15.7%) patients. Conclusions: Extracorporeal septoplasty is effective in improving both nasal airway function and aesthetics in patients with severe Nasal Septal deviation.

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Will Septal Correction Surgery for Deviated Nasal Septum Improve the Sense of Smell? A Prospective Study

Surgery Research and Practice ◽

10.1155/2015/496542 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Neelima Gupta ◽

P. P. Singh ◽

Rahul Kumar Bagla

Keyword(s):

Nasal Septum ◽

Small Sample Size ◽

Small Sample ◽

Septal Deviation ◽

Olfactory Function ◽

Deviated Nasal Septum ◽

Sense Of Smell ◽

Correction Surgery ◽

Olfactory Impairment ◽

A Prospective Study

Background and Objectives. Nasal obstruction due to deviated nasal septum is a common problem bringing a patient to an otorhinolaryngologist. Occasionally, these patients may also complain of olfactory impairment. We proposed to study the effect of septal deviation on the lateralised olfactory function and the change in olfaction after surgery of the septum (septoplasty).Methods. Forty-one patients with deviated nasal septum were evaluated for nasal airflow, olfactory score, and nasal symptomatology. Septoplasty was done under local anesthesia. Pre- and postoperative olfactory scores, airflow and olfactory scores, and nasal symptomatology and olfactory scores were compared and correlated.Results. The range of preoperative composite olfactory score (COS) on the side of septal deviation was 4–14 (mean7.90±2.234) and on the nonobstructed side was 9–18 (mean14.49±2.378). Severity of deviated nasal septum and preoperative COS of diseased side were correlated and the correlation was found to be significant (rho = −0.690,p=0.000(<0.001)). The preoperative mean COS (7.90±2.234) was compared with the postoperative mean COS (12.39±3.687) and the improvement was found to be statistically significant (p=0.000(<0.001)).Conclusion. We found improvement in olfactory function in 70.6% patients after surgery, no change in 20.1%, and reduced function in 7.6%. With the limitation of a small sample size and a potential repeat testing bias, we would conclude that correction of nasal septal deviation may lead to improvement in sense of smell.

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What is the Relationship Between Chronic Sinus Disease and Isolated Nasal Septal Deviation?

Otolaryngology ◽

10.1016/j.otohns.2005.04.013 ◽

2005 ◽

Vol 133 (2) ◽

pp. 190-193 ◽

Cited By ~ 26

Author(s):

Hasan Yasan ◽

Harun Doĝru ◽

Bahattin Baykal ◽

Fehmi Döner ◽

Mustafa Tüz

Keyword(s):

Risk Factor ◽

Nasal Septum ◽

Septal Deviation ◽

Control Group ◽

Moderate Degree ◽

Sinus Disease ◽

Nasal Septal Deviation ◽

Significant Difference ◽

The Relationship

Objective The aim of this retrospective study is to examine the role of isolated nasal septal deviation (NSD) in the pathogenesis of chronic rhinosinusitis (CRS). Study Design and Setting The interaction between isolated NSD and chronic sinus disease were retrospectively evaluated in 1452 patients. Out of 1452 patients, 152 patients were included in the study. Patients with anatomical variants other than NSD were excluded from the study. Patients with NSD were enrolled in the study group and patients without NSD were enrolled in the control group. Results There was no statistically significant difference between NSD group and non-NSD group with respect to the CRS. Conclusions The mild to moderate degree of NSD was not a risk factor for chronic sinus disease. Only gross deviation of the nasal septum itself is a risk factor for the development of CRS. Significance Excluding the subjects with ostiomeatal anatomic variations has differentiated this study from the previously reported researches (isolated NSD).

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Septopalatal Protraction for Correction of Nasal Septal Deformity in Cleft Palate Infants

Otolaryngology ◽

10.1016/j.otohns.2005.07.023 ◽

2005 ◽

Vol 133 (6) ◽

pp. 949-953 ◽

Cited By ~ 11

Author(s):

Corey C. Moore ◽

Ian MacDonald ◽

Ralph Latham ◽

Michael G. Brandt

Keyword(s):

Computed Tomography ◽

Cleft Palate ◽

Nasal Septum ◽

Airflow Obstruction ◽

Septal Deviation ◽

Nasal Airflow ◽

Nasal Septal Deviation ◽

Paired Student ◽

Angle Deviation ◽

Computed Tomography Scans

OBJECTIVE: It is proposed to test the practicality of septopalatal protraction in the unilateral cleft palate infant for purposes of straightening the nasal septum and thus relieving nasal airflow obstruction and its detrimental sequelae. METHODS: Alternate infants affected with complete unilateral palatal clefts had septopalatal protraction for a period of 6 to 8 weeks (protraction group; n = 4). Septal deviation was measured by a standardized technique that used computed tomography scans. The remaining infants had no protraction and served as controls (nonprotraction group; n = 5). Septal deviation was measured in the nonprotraction group from palatoseptal dental molds. RESULTS: A total of 9 patients were studied. All patients in the nonprotraction group had worsening of nasal septal deviation over a period of 8 weeks compared with the protraction group, which had complete nasal septal straightening. Differences in septal angle deviation between the protraction group and nonprotraction group at the end of the study were statistically significant ( P ≤ 0.01) as measured by the paired Student t test. CONCLUSIONS: Septopalatal protraction in the newborn appears to provide a means for correcting nasal septal deviation in complete unilateral cleft palate infants. Septopalatal protraction in the newborn is relatively easy and safe. EBM RATING: B-2

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SEPTOPLASTY AND BLOOD PRESSURE REDUCTION IN HYPERTENSIVE PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i3.640 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Dr. Krishna Murari Bansal ◽

Dr. Prithvi Raj Singh

Keyword(s):

Blood Pressure ◽

Nasal Cavity ◽

Nasal Septum ◽

Preoperative Evaluation ◽

Blood Pressure Reduction ◽

Vascular Complications ◽

Lateral Wall ◽

Septal Deviation ◽

Deviated Nasal Septum ◽

Total Distance

INTRODUCTION: Nasal septum is the bone and cartilage of the nose that separates the nasal cavity into two passages the space between the septum and the lateral walls of the nasal cavity regulates airflow and respiration. Nasal septum deviation is one of the most frequent reasons for nasal obstruction presented with a reduction in nasal airflow and chronic mucosal irritation. Abnormal upper airway resistance can play a role in the development of hypertension. Effective management of hypertension decreases the risk of, myocardial infarction, stroke, chronic kidney disease and heart failure. MATERIAL AND METHODS: Adults of both sexes with age range from 20–40 years, suffering from symptomatic nasal septal deviation and newly detected hypertension (mean BP ≥140/90 mm Hg), undergoing submucosal resection (SMR) of the deviated septum, were included in the study. Preoperative evaluation was done and detailed history was taken. asal septal deformities were classified according to the Dreher scale (0 = none i.e. no deviation, 1 = mild deviation i.e. deviation less than half of the total distance to the lateral wall, 2 = moderate deviation i.e. deviation greater than half of the total distance to the lateral wall but not touching it, 3 = severe deviation i.e. deviation touching the lateral wall). Compensatory inferior turbinate hypertrophy, when present, was noted. Hypertension was considered as controlled in patients who had a mean SBP <140 mm Hg and mean DBP <90 mm Hg on follow up, Patients in whom SBP was ≥140 mm Hg and/or DBP ≥90 mm Hg, were considered as uncontrolled hypertensive and they were started on medical treatment for hypertension. Postoperatively, patients were followed up after 1 month, 3 months and at the end of 1 year. RESULTS: Of the 50 patients included in the study 40 (80%) were male and 10(20%) were female. Mean age was 34 ± 4.56. Mild septal deviation was seen in 10(20%), moderate septal deviation was observed in 31 (62%) and severe septal deviation was seen in 9 (18%). Compensatory hypertrophy was observed in 11(22%) of cases. Mean preoperative SBP was 143.76 ± 2.78 mm Hg and mean DBP was 93 ± 1.55 mm Hg. Hypertension was controlled in 70 % of patients who showed a strongly significant (P < 0.001) decrease in BP about 10–12 mm Hg decrease in SBP and 4–5 mm Hg decrease in DBP. CONCLUSION: Patients with hypertension and deviated nasal septum, surgical correction is always indicated as it helps in reducing the blood pressure and thereby prevent cardio-pulmonary and cardio vascular complications secondary to hypertension.

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Endoscopic Septoplasty: Prospective Study in 50 Cases of DNS

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1161 ◽

2013 ◽

Vol 6 (2) ◽

pp. 92-95 ◽

Cited By ~ 1

Author(s):

Baldev Singh ◽

Kanu Singla ◽

Sanjeev Bhagat ◽

BS Verma

Keyword(s):

Prospective Study ◽

Nasal Obstruction ◽

Objective Assessment ◽

Septal Deviation ◽

Invasive Technique ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Nasal Septal Deviation ◽

Endoscopic Septoplasty ◽

Postnasal Drip

ABSTRACT Recently endoscopic septoplasty has emerged as an effective alternative to traditional ‘headlight’ approaches to septoplasty. Endoscopic septoplasty as a minimal invasive technique can limit the dissection and minimize trauma to nasal septal flap under excellent visualization. The present prospective study was conducted at the Department of ENT at Government Medical College, Rajindra Hospital, Patiala. Fifty cases of either sex in age group of 18 to 50 years suffering from deviated nasal septum were included in the study from May 2010 to November 2012. Among the prevalence of type of nasal septal deviation (Mladina classification), the most common type of nasal septal deviation was type 5 (46%) followed by type 6 (16%), type 2 (10%), type 4 (10%), type 3 (8%), type 7 (8%) and type 1 (2%). Among chief complaints most common was nasal obstruction in 38 (76%) followed by nasal discharge in 10 (20%), headache in 10 (20%), bleeding in 6 (12%) and postnasal discharge in 4 (8%) patients. There was improvement in nasal obstruction in 78%, nasal discharge in 60% and postnasal drip in 75% patients. On objective assessment at last follow-up (3 months), persistent inferior turbinate hypertrophy in 14%, and persistent deviation was seen in 4% of cases. Synechiae formation was seen in 4% of cases. How to cite this article Singla K, Singh B, Bhagat S, Verma BS. Endoscopic Septoplasty: Prospective Study in 50 Cases of DNS. Clin Rhinol An Int J 2013;6(2):92-95.

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