Efficiency of modified Goldman’s technique in open pediatric septoplasty

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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Role of septoplasty in allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203570 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1667

Author(s):

Hiten R. Maniyar ◽

Dharmishtha H. Parmar

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Obstruction ◽

Nasal Septum ◽

Common Symptom ◽

Age Group ◽

Control Test ◽

Deviated Nasal Septum ◽

Nose Scale

Background: It is a prospective study of 30 cases of allergic rhinitis with deviated nasal septum presented to our hospital. Analysis is done on the basis of age and sex distribution, severity of the symptoms pre and post operatively, according to nasal obstruction symptom evaluation (NOSE) scale and allergic rhinitis control test (ARCT) questionnaire which assess the quality of life.Methods: Detailed history taking and clinical examination was done. All the patients were assessed the severity of their symptoms based on a NOSE scale. An ARCT questionnaire was given to patients prior to surgery(septoplasty) and after 3 months of it.Results: In study we have observed that in the age group was 20-30years. Majority of the patients were males. The most common symptom is nasal obstruction followed by sneezing, rhinorhhea, pruritis, headache etc. The mean decrease in the NOSE score was statistically significant (before septoplasty NOSE score =14.6 and after septoplasty NOSE score=8.1). There is also improvement in quality of life which was measured by allergic rhinitis control test (ARCT) score. ARCT before septoplasty 10.2 and after 19.2.Conclusion: The study shows most common combined symptoms are nasal blockage with rhinorrhoea, more affecting the age group of 18 to 30 years, males, with deviated nasal septum towards left seen more commonly. Patients of allergic rhinitis with deviated nasal septum are benefited with septoplasty, improved symptoms like nasal obstruction and stuffiness etc. and the quality of life by decrease in the severity of allergic symptoms.

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Endoscopic Septoplasty Versus Traditional Septoplasty for Treating Deviated Nasal Septum: A Prospective, Randomized Controlled Trial

Ear Nose & Throat Journal ◽

10.1177/0145561320918982 ◽

2020 ◽

pp. 014556132091898

Author(s):

Shorook Na’ara ◽

Boris Kaptzan ◽

Ziv Gil ◽

Dimitry Ostrovsky

Keyword(s):

Quality Of Life ◽

Nasal Septum ◽

Controlled Trial ◽

Single Institution ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

Importance: This is the first randomized study to compare the quality of life of patients undergoing endoscopic septoplasty compared to traditional trans-nasal trans-speculum (TNTS) septoplasty. Objective: To assess the clinical outcomes and quality of life results of endoscopic versus TNTS septoplasty in patients with septal deviation and nasal obstruction. Design: A prospective, randomized controlled trial comparing 2 approaches of septoplasty: endoscopic and TNTS septoplasty performed in a single institution during the years 2016 to2017. The follow-up time was 3 months. Setting: A single institution study in a tertiary health-care referral center. Participants: Patients who underwent primary surgery for repairing deviated nasal septum due to nasal obstruction, were older than 18 years old, and were eligible for study inclusion. Sixty-five patients were enrolled in this study, 34 in the endoscopic arm and 31 in the TNTS septoplasty arm. The overall follow-up rate was 94% at the first visit (2 weeks) and 92% at the last visit (12 weeks). Thus, the final cohort consisted of 60 patients, 30 in each study arm. The patients ranged in age from 18 to 71 years (mean 27 years) old. Main Outcomes and Measures: The primary outcome was the Sino-Nasal Outcome Test-22 (SNOT-22) score. Secondary outcomes were the Short Form 36 (SF36) QOL score and complication rates. Both questionnaires were administered at 2 weeks and 3 months following surgery. Results: Sixty patients completed this study, 30 in each study arm. Sino-Nasal Outcome Test-22 scores were improved after 3 months, with no difference between the study arms. There were no cases of septal perforation or profound bleeding requiring repeated surgery. Conclusions and Relevance: Endoscopic septoplasty and TNTS show similar results for treatment of nasal septum deviation. Trial Registration: Traditional Septoplasty versus Endoscopic Septoplasty for Treating Deviated Nasal Septum, NCT02653950. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005ZOR&selectaction=Edit&uid=U00021YC&ts=2&cx=-2w7hot .

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CLINICAL PROFILE OF CHRONIC RHINOSINUSITIS: A STUDY IN CENTRAL INDIA

10.36106/paripex/1809951 ◽

2021 ◽

pp. 104-106

Author(s):

Tanvi Rekhade ◽

A.Z. Nitnaware ◽

Seema Patel ◽

R.T. Pawar ◽

Ashish Keche

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Septum ◽

Nasal Polyps ◽

Central India ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Northern India ◽

Causative Factors

Chronic Rhinosinusitis (CRS) has heavy implications on the quality of life and has a prevalence of about 46.1 % in northern India with similar pattern across the country.This research has been undertaken to study the presentation and causative factors for CRS in central India. Data of 100 patients diagnosed as CRS was studied. Patients presented with nasal obstruction and nasal discharge at large. Nasal polyps were seen in 37% cases. The most common associated etiopathological factor was anatomical obstruction due to deviated nasal septum.

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Assessment of Septoplasty Outcome using Nasal Obstruction Symptom Evaluation Scale

Nepal Medical College Journal ◽

10.3126/nmcj.v21i2.25114 ◽

2019 ◽

Vol 21 (2) ◽

pp. 142-146

Author(s):

Kundan Kumar Shrestha ◽

R.R. Joshi ◽

A.S. Rijal ◽

A. Dhungana ◽

S. Maharjan

Keyword(s):

Quality Of Life ◽

Nasal Obstruction ◽

Septal Deviation ◽

Definitive Treatment ◽

Nose Scale ◽

Outcome Instrument ◽

Symptom Evaluation ◽

The Mean ◽

Nasal Septoplasty

Nasal obstruction, the most common presenting symptom in nasal and sinus disease, is defined as patient discomfort manifested as a sensation of insufficient airflow through the nose. Nasal septal deviation is the most common anatomical cause of nasal obstruction. Surgical correction of a deviated septum, nasal septoplasty, is the definitive treatment for septal deviation. Many studies have discussed about outcomes of septoplasty. However, there is limited published literature on nasal septoplasty and its outcome in Nepal. The aim of this study is to evaluate the outcome of septoplasty using Nasal Obstruction Symptom Evaluation (NOSE) scale, a validated outcome instrument assessing quality of life (QoL) related to nasal obstruction. A total of 52 patients aged 18 years and above, with nasal obstruction at least for 3 months, undergoing septoplasty alone were included in the study. Baseline NOSE score was calculated a week before surgery. The patients were followed up after 3 months to record postoperative NOSE score. On statistical analysis, the mean NOSE scores before and 3 months after septoplasty were 45.58±21.38 and 8.46±8.37 respectively. The mean difference was 37.11± 21.22 and p value on paired t test was less than 0.001(highly significant). The mean differences of each component of the NOSE scale questionnaire were also found to be highly significant statistically with p values less than 0.001. Gender and age did not seem to affect the outcomes. In conclusion, NOSE scale is a valid, reliable and responsive instrument that is brief and easy to complete and has potential use for outcome studies in adults with nasal obstruction. This instrument showed that septoplasty, if done in properly selected patients, results in significant improvement in nasal obstruction and disease specific quality of life with high patient satisfaction.

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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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Results of surgical treatment of children with PFAPA syndrome

Medical Council ◽

10.21518/2079-701x-2019-17-244-251 ◽

2019 ◽

pp. 244-251

Author(s):

A. S. Yunusov ◽

T. I. Garashchenko ◽

P. I. Belavina ◽

A. G. Ryazanskaya ◽

E. V. Molodtsova ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Multidisciplinary Approach ◽

Pediatric Population ◽

Quality Of Life Indicators ◽

Before And After ◽

Pfapa Syndrome ◽

Primary School Age

Rationale. Currently, the literature describes about 374 cases of Marshall syndrome. According to some authors, the prevalence of Marshall syndrome is 2.3 per 10,000 children, in general, the epidemiology of PFAPA syndrome in the pediatric population is unknown.Purpose. The aim of our study is to justify surgical treatment in children with Marshall syndrome. Objectives. The objectives of this study are to give a comparative assessment of the effectiveness of tonsillectomy and adenotonzyllectomy for this syndrome and to evaluate the quality of life indicators before and after surgical treatment.Materials and methods. The study included 26 patients with Marshall syndrome, of which 18 patients underwent adenotonzyllectomy and 8 patients underwent bilateral tonsillectomy. A clinical case of a typical manifestation of Marshall syndrome is also described, and follow-up results of the effectiveness of surgical treatment for Marshall syndrome are presented. In the course of the work, an adapted questionnaire was developed to assess the quality of life of parents of children with Marshall syndrome.Results. The result of our work is the fact that in relation to the relief of PFAPA-syndrome, children of preschool and primary school age have more effective adenotonsillectomy (88.2%), while tonsillectomy was effective only in 55.6% of patients.Conclusion. A multidisciplinary approach is required to address the diagnosis and treatment of Marshall syndrome.

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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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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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