An endoscopic approach to the deviated nasal septum – a preliminary study

AbstractThe authors have used the nasal endoscope for the precise identification of pathological abnormalities of the nasal septum in relation to the lateral nasal wall including the osteo-meatal complex and in its ultraconservative management. The aim of the study was to compare the efficacies of endoscope-aided septoplasty (EAS) over traditional septoplasty (TS) in treating the pathological septum and turbinates, performed in 30 cases each. The subjective assessment was carried out by visual analogue scores and objective assessment by nasal endoscopy. This study demonstrates the superiority and limitations of the endoscopic approach in managing a deviated nasal septum and the turbinates. The endoscope-aided technique was found to be more effective in relieving the contact areas and nasal obstruction (p = ≤0.05). The authors advocate a combined approach – an endoscopic approach for inaccessible posterior deviation and the conservative traditional technique for accessible anterior deviation of the nasal septum.

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A comparative study of endoscopic versus conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203205 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1490

Author(s):

Ramniwas Dhaka ◽

Pooja Arya ◽

Deep Chand ◽

Vivek Samor ◽

Ramchander Bishnoi ◽

...

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Objective Assessment ◽

Posterior Part ◽

Sinus Surgery ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Surgery Patient ◽

Group A ◽

Group B

Background: Deviated nasal septum is one of the common causes of nasal obstruction. Correction of deviated nasal septum has been performed by a variety of techniques of which Septoplasty is the most popular one. With the advent of endoscopes and their successful use in endoscopic sinus surgery endoscopes have been tried in septoplasty for better visualization of posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplasty.Methods: It was a prospective observational study conducted on 50 patients with deviated nasal septum, who presented to ENT department of SPMC, Bikaner, patients were randomly divided equally in two groups for conventional and endoscopic septoplasty respectively. Data collected on a prestructured proforma and results analysed. Results: The study included 50 cases. Postoperatively significant relief from the symptoms of nasal obstruction (82%) in group A and (96%) group B, was seen. In objective assessment at the end of 3 months of surgery, patient had persistent posterior deviation 24% in group A and 3% in group B, spur 12% in group A and 0% in group B.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

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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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Study to Compare and Evaluate Traditional vs. Endoscopic Septoplasty

Kathmandu University Medical Journal ◽

10.3126/kumj.v13i2.16782 ◽

2017 ◽

Vol 13 (2) ◽

pp. 109-114

Author(s):

I. Shrestha ◽

M. Pokharel ◽

A. Dhakal ◽

R.C.M. Amatya

Keyword(s):

Nasal Obstruction ◽

Objective Assessment ◽

Objective Evaluation ◽

Subjective Assessment ◽

P Value ◽

Deviated Nasal Septum ◽

Post Surgery ◽

Postnasal Drip ◽

Septal Surgery ◽

Evolutionary Step

Background Surgery on a deviated septum has seen several modifications since its inception starting from radical septal resection to preservation of the possible septal framework.Objective To compare the efficacies of “Endoscope Septoplasty” over “Traditional Septoplasty” in treating pathological septum and turbinates, in terms of their outcome.Method Prospective descriptive study conducted on 60 patients who presented to the Department of ENT, Kathmandu University School of Medical sciences during a period of two years. The severity of the symptoms of the patients was scored using a visual analogue scale which was compared post operatively to subjectively evaluate the efficacy of either surgery. Objective assessment was done by nasal endoscopy. P value in case of subjective and objective evaluation was done by applying Z- test.Result The mean age ± SD was 29.5±1.2 .Maximum patients fell into age group of 21-30 with 31.7 % followed by 11-20 with 28.3% and then 31-40 with 25 %. There were total 35 males (58.3%) and 25 females (41.7%). Among the symptoms, nasal obstruction seems to be dominating with total of 83.3%, followed by postnasal drip with 66.6% and then headache with 60%. The types of dislocation was compared, there were 66.7% cases with DNS and Spur whereas only 10 % with isolated spur. C shaped deformity was seen in 30% and S shaped in 26.6 % cases. Significance in Z test, is seen in subjective assessment post surgery for nasal obstruction, headache and rhinorrhea and for objective assessment post surgery for persistent contact with turbinates. (p value set to 0.01)Conclusion Endoscopic surgery is an evolutionary step towards solving the problems related to deviated nasal septum. It is safe, effective and conservative alternative to conventional septal surgery.

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A comparative study of endoscopic versus conventional septoplasty: an analysis of 50 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174330 ◽

2017 ◽

Vol 3 (4) ◽

pp. 1046

Author(s):

Sagar Chandra ◽

Nitish Baisakhiya

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Posterior Part ◽

Surgical Correction ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Nasal Endoscope ◽

Endoscopic Septoplasty ◽

Group A ◽

Group B

Background: Nasal obstruction is the most common complaint in ENT practice. Surgical correction of deviated nasal septum has been performed by a variety of techniques of which sub mucous resection and Septoplasty procedures of surgical correction of nasal septum play a prime role in management of patients of nasal obstruction. Nasal endoscope is very useful tool to visualize posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplastyMethods: 50 cases (between (Oct. 2014 - March 2016) of deviated nasal septum selected in this prospective study and they were randomly divided equally in 2 groups for endoscopic (A) and conventional (B) septoplasty respectively. Results: The study included 50 cases. Majority of patients in this study were males 84% (n=42) and 16% (n=18) were female. 46% (n=23) patients had DNS to right side and 54% (n=27) patients had left side, anterior deviation (48%). C and S shaped deviations (14%). Spur was present in 22% (n=11) of cases and 10% (n=5) patients presented with thickening. After completing 2 months of follow up 92% (n=23) of group A and 88% (n=22) of group B were relieved from nasal discharge, while nasal obstruction was absent in 96% (n=24) patients of group A and 80% (n= 20) of group B. 4% cases (n=1) in endoscopic septoplasty was having persistent deviated nasal septum and 16% (n=4) patients of conventional septoplasty belong to this group.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

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The Common Clinical Presentation of Patients Selected for Septoplasty in Northern Saudi Arabia

International Journal of Otolaryngology ◽

10.1155/2018/8536387 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Abdullah D. Alotaibi ◽

Bassam Ahmed Almutlaq ◽

Fahad Nashmi Alshammari ◽

Hussain Gadelkarim Ahmed

Keyword(s):

Saudi Arabia ◽

Nasal Obstruction ◽

Nasal Septum ◽

Clinical Presentation ◽

Critical Role ◽

Deviated Nasal Septum ◽

Clinical Presentations ◽

Common Clinical Presentation ◽

The Common ◽

Almost All

Background. Nasal septal deviation (NSD) plays a critical role in nasal obstruction symptoms, aesthetic look of the nose, increased nasal resistance, and occasionally snoring. Septoplasty is the most common method for correction of deviated nasal septum (DNS). Therefore, the aim of the present study was to assess the association between initial clinical presentations of patients selected for septoplasty and demographical characteristics in Northern Saudi Arabia.Methodology. Archives related to all patients selected for septoplasty between 2012 and 2017 were retrieved from ENT Department at King Khalid Hospital in Hail, Northern Saudi Arabia. Only adults over 18 years of age were included in this study.Results. With regard to the clinical presentations, almost all patients presented with variable degrees of nasal congestions, nasal blockages, breathing troubles, sleeping troubles, and exercise problems.Conclusion. Nasal obstruction is prevalent in Northern Saudi Arabia with peaks being in the years 2016 and 2014 with the most etiological factor being DNS.

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Prevalence and clinical features of nasal septum deviation: a study in an urban centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173670 ◽

2017 ◽

Vol 3 (4) ◽

pp. 842 ◽

Cited By ~ 2

Author(s):

Vinnakota Sriprakash

Keyword(s):

Nasal Cavity ◽

Nasal Obstruction ◽

Nasal Septum ◽

Critical Role ◽

Geographical Area ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Septum Deviation ◽

Aesthetic Appearance ◽

Nasal Septum Deviation

Background: Considerably large nasal septum plays a critical role in the obstruction of the nasal cavity, leading to snoring, and other symptoms, aesthetic appearance of the nose, and increased nasal resistance. This study was performed with an aim to investigate the prevalence of nasal septum deviation in our geographical area.Methods: 446 patients who attended the ENT department in the study period were evaluated for the nasal septum deviation. General demographic details were obtained from all of them. Detailed physical exam was performed on all the patients. Disposable nasal speculum and otoscope was used to observe the interior of the nasal cavity. Results: Out of 446 patients visiting the ENT department of our hospital, 138 (30.9%) of them had DNS. The C shaped NSD was the most common type to be encountered in our study, with 57 patients showing this disorder. Nasal obstruction was the predominant symptom observed in 119 (86.2%) of the patients, followed by rhinitis and nasal discharge (34.8%).Conclusions: Deviated nasal septum is a very prevalent condition in our area, with severe symptoms such as nasal obstruction and rhinitis. Most of the patients had C shaped deviated septum.

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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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CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v21i2.27646 ◽

2016 ◽

Vol 21 (2) ◽

pp. 90-93

Author(s):

Mirza Aneesa ◽

Sajad Majid Qazi ◽

Aijazul Haq

Keyword(s):

Paranasal Sinuses ◽

Nasal Septum ◽

Complex Disease ◽

Anatomical Variation ◽

Middle Turbinate ◽

Inferior Turbinate ◽

Anatomical Variations ◽

Lateral Nasal Wall ◽

Deviated Nasal Septum ◽

Osteomeatal Complex

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93

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COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

10.36106/ujsr/5425585 ◽

2021 ◽

pp. 62-65

Author(s):

Subhadeep Chowdhury ◽

Tithi Debnath ◽

Sweta Verma

Keyword(s):

Comparative Study ◽

Nasal Obstruction ◽

Nasal Septum ◽

Tertiary Care ◽

Inferior Turbinate ◽

Deviated Nasal Septum ◽

Nose Scale ◽

Nasal Symptoms ◽

Group A ◽

Group B

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

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