Comparative study of outcomes of conventional and  endoscopic septoplasty

Background: Literature and other available research states lots of comparison between endoscopic and conventional septoplasty. The study helps conclude the merits and demerits of both techniques and compares the superiority of one method over the other on various aspects from surgeon’s and patient’s point of view. The objective of the study was to compare outcomes of conventional and endoscopic septoplasty.Methods: Study included 48 patients having symptomatic deviated nasal septum willing for surgery randomly divided into two groups of 24 each who underwent endoscopic septoplasty and conventional septoplasty. All the patients selected for study, were assessed for subjective and objective evaluation pre-operatively and post-operatively on 7th day, 1 month and 3 months. The study was conducted at Surat Municipal Institute of Medical Education and Research (SMIMER), Surat.Results: There are technical advantages of using endoscope during septoplasty as it is definitely superior from surgeon’s point of view but there is no significant difference in terms of functional outcome, complications and post-operative hospital stay.Conclusions: There are technical advantages of using endoscope being superior in terms of illumination, preciseness and surgery, visualization of deeper parts of nasal cavity and resection of posterior deviation and spur especially in isolated septal spur and in achieving hemostasis. The study helps us conclude that endoscopic septoplasty has merits over conventional septoplasty on various aspects.

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Comparative Study between Endoscopic Aided Septoplasty with Two Handed Technique using Endoholder and Conventional Septoplasty

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i3.29193 ◽

2020 ◽

Vol 16 (3) ◽

Author(s):

Apar Pokharel ◽

Naganawalachullu Jaya Prakash Mayya ◽

Nabin Gautam

Keyword(s):

Comparative Study ◽

Nasal Septum ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Septal Surgery ◽

Significant Difference ◽

Common Causes ◽

Prospective Comparative Study ◽

Evolutionary Step ◽

One Year

Introduction: Deviated nasal septum is one of the most common causes for the nasal obstruction. The objective of this study is to compare the surgical outcomes in patients undergoing conventional septoplasty and endoscopic septoplasty in the management of deviated nasal septum. Methods: Prospective comparative study was conducted on 60 patients who presented to the Department of ENT, College of Medical sciences, during a period of one year. The severity of the symptoms was subjectively assessed using NOSE score and objectively assessed using modified Gertner plate. Results: There was significant improvement in functional outcome like NOSE Score and area over the Gertner plate among patients who underwent endoscopic septoplasty. Significant difference in incidence of post-operative nasal synechae and haemorrhage was seen in conventional group compared to endoscopic group. Conclusions: 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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Perioperative management of patients with operated nasal cavity and paranasal sinuses

Russian otorhinolaryngology ◽

10.18692/1810-4800-2021-4-102-109 ◽

2021 ◽

Vol 20 (4) ◽

pp. 102-109

Author(s):

E. L. Savlevich ◽

◽

T. G. Pelishenko ◽

V. S. Kozlov ◽

F. N. Koryagin ◽

...

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Nasal Septum ◽

Antimicrobial Agents ◽

Perioperative Period ◽

Objective Evaluation ◽

Infectious Complications ◽

Deviated Nasal Septum ◽

Systemic Antibiotic Therapy ◽

Significant Difference

Nowadays due to the growth of the antibiotic resistance of the bacteria, the issue of the perioperative prophylaxis in surgery of the nasal cavity and paranasal sinuses has become especially relevant. Although the use of antibiotics more than 24 hours after surgery for prophylactic purposes does not increase the effectiveness of perioperative prevention of infectious complications, systemic antibiotics are often continued in the otorhinolaryngology departments for 5-7 days after surgery. Objective: Evaluation of the possibility of using of alternative antimicrobial agents in the framework of perioperative prevention of infectious complications during operations of the nasal cavity and paranasal sinuses. 178 patients undergoing surgical treatment for deviated nasal septum, chronic hypertrophic rhinitis, chronic rhinosinusitis without polyps, were divided into 2 groups. In the first group, 2 weeks before the operation and within 7 days of the postoperative period, applications were applied to the nasal cavity with a gel with Otofag bacteriophages, 2 doses 3 times a day for 60 minutes. In the second group, systemic antibiotic therapy (ceftriaxone 1.0 intramuscularly once) was prescribed 40-60 minutes before the operation. Results: There wasn’t a significant difference in the regression of reactive phenomena of the nasal mucosa and intoxication syndrome, except for the intensity of crust formation in the nasal cavity, the severity of which was 1.9 ± 0.1 points in the first and 4.19 ± 0.54 points in the second group on the 7’th day after surgery. Conclusion: The use of the gel with Otofag bacteriophages can be recommended in the perioperative period during planned operations on the nasal septum, inferior turbinates, and paranasal sinuses, which will allow avoiding the use of standard antibacterial drugs in these patients.

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Comparative evaluation of conventional versus endoscopic septoplasty for limited septal deviation and spur

The Journal of Laryngology & Otology ◽

10.1017/s0022215108004192 ◽

2008 ◽

Vol 123 (7) ◽

pp. 737-741 ◽

Cited By ~ 23

Author(s):

R Bothra ◽

N N Mathur

Keyword(s):

Nasal Obstruction ◽

Block Design ◽

Objective Evaluation ◽

Septal Deviation ◽

Sinus Surgery ◽

Endoscopic Septoplasty ◽

Significant Difference ◽

Operative Complications ◽

Operative Assessment ◽

Septal Spur

AbstractObjective:To compare the procedure, results and complications of conventional septoplasty with those of endoscopic septoplasty, in cases of limited septal deviation and septal spurs.Design:Prospective study; interventional type; randomised block design; comparative clinical trial.Methods:We included in the study 80 patients presenting with limited septal deviation, septal spur with nasal obstruction, or deviated septum with septal correction was required in order to access the ostio-meatal complex (OMC) for functional endoscopic sinus surgery. Of these 12 were children with septal deviation producing significant nasal obstruction. All patients were divided into two groups- with one undergoing conventional and the other endoscopic septoplasty. Post-operative assessment was carried out one month, three months and one to two years after the procedure.Result:Post-operative complications such as haemorrhage, infraorbital oedema, nasal pain and in-patient hospital was slightly more in the conventional septoplasty group.Conclusion:No statistically significant difference was found between the conventional and endoscopic septoplasty groups, as assessed by subjective and objective evaluation.

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A comparative study of endoscopic septoplasty and conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200565 ◽

2020 ◽

Vol 6 (3) ◽

pp. 453

Author(s):

Kiran A. Deshmukh ◽

Rashmi T. Ambiger

Keyword(s):

Comparative Study ◽

Prospective Study ◽

Hospital Stay ◽

Nasal Septum ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Advantages And Disadvantages ◽

Duration Of Surgery ◽

A Prospective Study ◽

Endoscopic Group

Background: The aim of the study was to study the advantages and disadvantages of endoscopic septoplasty and conventional septoplasty and to co-relate the two procedures in terms of intra-operative visualization, duration of surgery, procedural difficulties, hospital stay and complications.Methods: It is a prospective study done during November 2017 to April 2019 on 50 patients with symptomatic deviated nasal septum. Patients were randomly divided into conventional septoplasty and endoscopic septoplasty groups of 25 each. Surgery was performed as according to the division. Followed up on 1st week, 15th day, 1st month and 3rd month. Results: In endoscopic septoplasty group, septal pathology, precise correction of the pathology, with less complications were seen. Hospital stay and duration of surgery were significantly less in endoscopic group.Conclusions: For minimal and posterior deviations of the septum, endoscopic septoplasty is better, whereas for anterior deviations, conventional septoplasty could be better choice.

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A comparative study of conventional septoplasty versus endoscopic septoplasty

10.25259/aujmsr_8_2019 ◽

2019 ◽

Vol 1 ◽

pp. 27-30

Author(s):

Bavneet Kour ◽

Grace Budhiraja ◽

Kunzes Dolma ◽

Danish Guram

Keyword(s):

Nasal Septum ◽

Inferior Turbinate ◽

Simple Random Sampling ◽

Conservative Surgery ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Female Ratio ◽

Endoscopic Septoplasty ◽

Deviated Septum ◽

Postnasal Drip

Introduction: A deviated septum can be asymptomatic or can cause functional and cosmetic abnormalities. Different studies have been proposed for the correction of deviated septum, but septoplasty has been the treatment of choice. Septoplasty is a more conservative surgery and endoscopic septoplasty has become increasingly popular over the past few decades. Materials and Methods: The study was carried out to compare the post-operative results among patients of conventional and endoscopic septoplasty and to assess the efficacy of endoscopic septoplasty with other surgeries. The present study was conducted among 40 patients of deviated nasal septum admitted in the Department of Otolaryngology of Adesh Institute of Medical Sciences and Research, Bathinda. Patients were selected by simple random sampling and were divided into Groups A and B, with 20 patients in each group. Group A underwent conventional septoplasty and Group B underwent endoscopic septoplasty. Results: The male-to-female ratio in the present study was 3:1. Deviated nasal septum was commonly associated with inferior turbinate hypertrophy (45%) and concha bullosa (27.5%). Postoperatively, a significant relief from the symptoms of nasal obstruction (85%), nasal discharge (25%), headache (30%), and postnasal drip (55%) was observed in endoscopic septoplasty. Complication rate was higher in conventional septoplasty. The endoscopic approach facilitates proper alignment by limited and precise resection of pathological areas. Conclusion: Endoscopic septoplasty provides precise resection of the pathological areas and better illumination with limited flap dissection and exposure.

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Which is the best treatment of pediatric upper urinary tract stones among extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery: a systematic review

BMC Urology ◽

10.1186/s12894-019-0520-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Qing He ◽

Kaiwen Xiao ◽

Yuntian Chen ◽

Banghua Liao ◽

Hong Li ◽

...

Keyword(s):

Hospital Stay ◽

Operative Time ◽

Upper Urinary Tract ◽

The Other ◽

Efficacy And Safety ◽

Retrograde Intrarenal Surgery ◽

Lower Efficiency ◽

Significant Difference ◽

Urinary Tract Stones ◽

Retreatment Rate

Abstract Background Although the indications of minimally invasive treatments for pediatric urolithiasis are similar to those in adults, it is still crucial to make the right treatment decision due to the special considerations of children. This review aims to evaluate the efficacy and safety of extracorporeal shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS) in the management of pediatric upper urinary tract stones. Methods EMBASE, PubMed, and the Cochrane Library were searched from their first available date to March 2018. The studies that meet the inclusive criteria were included. The efficacy and safety of the treatments were assessed by means of meta-analysis of the stone free rate (SFR), complication rate, effectiveness quotient (EQ) and secondary outcome indicators. Results A total of 13 comparative studies were identified for data analysis. PCNL presented a significantly higher SFR compared with SWL. Similarly, the single-session SFR of RIRS was significantly higher than SWL. However, no significant difference was found between RIRS and SWL in the overall SFR. There was no significant difference between PCNL and RIRS in the SFR. Furthermore, no significant differences in complication rates were found among the three therapies. Compared with the other two treatments, PCNL had a longer operative time, fluoroscopy time and hospital stay. SWL had a shorter hospital stay, higher retreatment rate and auxiliary rate in comparison with the other two treatments. The present data also showed that PCNL presented a higher EQ than the other two treatments, and RIRS had a lower efficiency than SWL and PCNL. In the subgroup analysis of pediatric patients with stone ≤20 mm, the comparative results were similar to those described above, except for the higher complication rate of PCNL than SWL. Conclusions Although SWL as an outpatient procedure provides shorter hospital stay and reduces operative time, it has a lower SFR and higher retreatment rate than the other two treatments. PCNL exhibits a higher SFR and EQ than SWL; nevertheless, it has a longer operative time and fluoroscopy time than the other two procedures. RIRS offers a similar SFR as PCNL but a lower efficiency than PCNL.

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Advantages and Limitations of Endoscopic Septoplasty: Experience of 120 Cases

Volume 5 - 2020, Issue 9 - September - International Journal of Innovative Science and Research Technology ◽

10.38124/ijisrt20jul216 ◽

2020 ◽

Vol 5 (7) ◽

pp. 233-238

Author(s):

Md. Ashraful Islam ◽

Tareq Mohammad ◽

Nazmul Hossain Chowdhury ◽

Towsif Bin Mamoo ◽

Farid Uddin Milki ◽

...

Keyword(s):

Nasal Septum ◽

Endoscopic Approach ◽

Sinus Surgery ◽

Deviated Nasal Septum ◽

Patient’S Satisfaction ◽

Male Predominance ◽

Endoscopic Septoplasty ◽

Additional Surgery ◽

Number Of Patients ◽

A Prospective Study

Objective: Traditional surgeries for the deviated nasal septum improves the nasal airway but recent development and advancement of the knowledge about endoscope has changed the treatment modality significantly. Endoscopic approach under good Illumination and magnification lessen the complication. This study is done to see the advantages and limitations of endoscopic septoplasty Method: Total 120 cases of symptomatic deviated nasal septum, refractory to conservative medical treatment were randomly selected on the basis of clinical examination in a single institute. It was a prospective study, performed to see the advantages and limitations of endoscopic septoplasty. Informed written consent was taken in all cases. All the patients underwent endoscopic septoplasty under general anesthesia after proper evaluation. Results: There was a slight male predominance. 13 year child was the youngest patient and 58 was the oldest. During endoscopic septoplasty a large number of patients needed some additional surgery like, inferior turbinoplasty in 27 (22.5%), functional endoscopic sinus surgery in 11 patients (9.16%) etc. The complication rate was minimum (4.16%). Patient’s satisfaction was high. Though there were some limitations but we observed so many advantages of this procedure. Conclusion: Though conventional Septoplasty is widely practiced by most ENT surgeons till now, the endoscopic approach can be considered as a better alternative

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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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Aneurysmal bleed in traumatic SAH: are we missing something serious?

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15296 ◽

2016 ◽

Vol 18 (3) ◽

pp. 33

Author(s):

Suvechha Waiba ◽

Archana Joshi ◽

Karjome Lama ◽

Bidur KC ◽

Bikram Shakya ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Hospital Stay ◽

Aneurysm Rupture ◽

The Other ◽

Significant Difference ◽

History Of ◽

High Index Of Suspicion ◽

Spontaneous Subarachnoid Hemorrhage ◽

Neurological Surgery ◽

Or History

Introduction and Objective: Spontaneous Subarachnoid hemorrhage (SAH) is usually due to aneurysm rupture (85%) however SAH is far common in traumatic brain injury (TBI) (60%). We did an audit to see proportion of our patients with TBI with SAH and their outcomeMaterials and Methods: We did a retrospective study of patients admitted with Department of neurological surgery since April 2012 till Jan 2016. We included all patients with traumatic SAH and subjected patients with significant cisternal bleed or history of dizziness or headache prior to fall or injury to brain CT angiography. Patient who could not be properly evaluated despite suspicion were excluded. Endpoints studied were outcome, hospital stay and morbidity.Results: 112 patients were studied of which 63 were males and mean age was 48.2 years. Total of 5 cases (4.5%) had intracranial aneurysm. Of these, 3 were PCOM aneurysm and 2 from ACOM. These were successfully clipped and no significant difference in hospital stay or morbidity was seen. Of the other followed up patients, none had recurrent bleed. We discuss our approach and limitations of this study.Conclusion: 5% patients with traumatic SAH had aneurysm. A high index of suspicion and early clipping of aneurysm in such cases is associated with good outcome.

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Is Septoplasty Necessary When Using the Endoscopic Endonasal Transsphenoidal Approach for a Deviated Nasal Septum?

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1641602 ◽

2018 ◽

Vol 79 (06) ◽

pp. 569-573

Author(s):

Do Hyun Kim ◽

Yong-Kil Hong ◽

Sin-Soo Jeun ◽

Jae-Sung Park ◽

Soo Whan Kim ◽

...

Keyword(s):

Nasal Cavity ◽

Nasal Septum ◽

Middle Turbinate ◽

Case Series ◽

Septal Cartilage ◽

Transsphenoidal Approach ◽

Deviated Nasal Septum ◽

Endoscopic Endonasal ◽

Significant Difference ◽

Group B

Objective This article describes the role played by endoscopic endonasal transsphenoidal approach (EETSA) to the sphenoidal process of the septal cartilage of a deviated nasal septum. Design Case series with chart review. Setting Tertiary referral center. Participants Between 2009 and 2016, 177 patients with skull base tumors who underwent EETSA were included. Main Outcome Measures In 8 cases, the conventional two nostrils–four hands technique was employed (group A). In 16 cases, we placed a right-side conventional nasoseptal flap and a left-side modified nasoseptal rescue flap (group B), and in 153 cases, bilateral modified nasoseptal rescue flaps (group C). The number of septoplasty-required cases and the change of nasal cavity area differences reflecting septal deviation were measured. Results Septoplasty during EETSA was performed in two cases: one from group B and one from group C. There was no significant difference in the ratio of septoplasty-required cases among the three groups (p = 0.127). Between pre- and postoperative nasal cavity, the cross-sectional area difference at the anterior end of the middle turbinate level significantly decreased (p = 0.045). Also, the angle of deviation at the level of ostiomeatal unit significantly decreased after EETSA (p < 0.001). Conclusion Separation of a deviated complex surrounding the sphenoidal process of the septal cartilage is the key to relieving a deviated nasal septum. EETSA combined with the two nostrils–four hands technique allows posterior septectomy (including removal of this deviated complex) to be performed. Thus, EETSA may commence without preceding septoplasty even in cases with severe nasal septum deviations.

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