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

Background: Conventional surgeries of the nasal septum improve the nasal airway but recent development and advancement of the knowledge about the endoscopic septoplasty has significantly changed the treatment modality and had brought focus over several aspects of possible advantages. This study aims to see the advantages, complications and limitations of endoscopic septoplasty. Methods: It was an observational prospective study conducted over 90 patients of symptomatic deviated nasal septum. It evaluated symptoms, anterior rhinoscopy and nasal endoscopy findings, objective and subjective improvement of symptoms using the nasal obstruction symptom evaluaiton (NOSE) score, post-operative pain using the visual analogue scale (VAS) and complication following the surgery. Results: Deviated nasal septum (DNS) either left or right side was the most common examination finding 97.78%. Post-operatively there was a good symptom relief and significant subjective improvement in NOSE scores with average decline in the score by 96.26%. Objective assessment of all patients showed improved airway. The complication rate was minimum 7.78%. Conclusion: Endoscopic septoplasty (ES) was found to have distinct advantages with good subjective and objective improvement of symptoms and lesser rate of complications. It should be an option offered to all patients requiring septoplasty. We also found that it helps in improving the learning curve and surgical skill of the trainees. Bangladesh J Otorhinolaryngol 2021; 27(2): 170-176

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215100142124 ◽

1998 ◽

Vol 112 (10) ◽

pp. 934-939 ◽

Cited By ~ 20

Author(s):

Dipak Ranjan Nayak ◽

R. Balakrishnan ◽

K. Deepak Murthy

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Objective Assessment ◽

Subjective Assessment ◽

Endoscopic Approach ◽

Lateral Nasal Wall ◽

Combined Approach ◽

Deviated Nasal Septum ◽

Nasal Endoscope ◽

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 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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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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Comparison between Endoscopic Septoplasty and Conventional Septoplasty: Our Experience

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1242 ◽

2015 ◽

Vol 8 (3) ◽

pp. 93-98

Author(s):

Kandakure Vinod Tukaram

Keyword(s):

Functional Outcome ◽

Surgical Procedures ◽

Nasal Septum ◽

Randomized Study ◽

Functional Results ◽

Government Medical College ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Medical College ◽

The Difference

ABSTRACT Introduction Nasal obstruction due to deviated nasal septum is a common problem encountered by otolaryngologists. A variety of surgical procedures have been tried in the treatment of the same. Objective This study was conducted to evaluate the outcomes and complications of endoscopic and conventional septoplasty. Materials and methods This is a prospective, randomized study done in Government Medical College, Latur in which 52 patients with symptomatic deviated nasal septum were included in the study. Eighteen of them underwent conventional septoplasty and the rest had endoscopic septoplasty. Results The difference in the functional outcome of both the surgeries was insignificant. Endoscopic septoplasty had better outcome with respect to complications and proved as an easier method to correct posterior deviations and isolated spurs. Conclusion Endoscopic septoplasty allows accurate, conservative repair of obstructive nasal septum deviations, with fewer complications and better functional results compared to conventional septoplasty. How to cite this article Tukaram KV, Lahane VJ, Mishra S, Prakash NP. Comparison between Endoscopic Septoplasty and Conventional Septoplasty: Our Experience. Clin Rhinol An Int J 2015;8(3):93-98.

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Comparative study of outcomes of conventional and endoscopic septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212901 ◽

2021 ◽

Vol 7 (8) ◽

pp. 1325

Author(s):

Kush B. Pandya ◽

Manit M. Mandal ◽

Ajay K. Panchal ◽

Rakesh Kumar ◽

Parth B. Kapadia ◽

...

Keyword(s):

Medical Education ◽

Hospital Stay ◽

Nasal Septum ◽

Objective Evaluation ◽

Point Of View ◽

The Other ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Significant Difference ◽

Septal Spur

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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Endoscopic Septoplasty: Advantages and Disadvantages

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1022 ◽

2010 ◽

Vol 3 (1) ◽

pp. 27-30 ◽

Cited By ~ 3

Author(s):

Shashidhar S Suligavi ◽

MK Darade ◽

BD Guttigoli

Keyword(s):

Nasal Septum ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Advantages And Disadvantages ◽

Postoperative Symptoms

Abstract Our study was conducted to assess the advantages and disadvantages of use of endoscopes use in septoplasty. Hundred patients with symptomatic deviated nasal septum were randomly divided into endoscopic septoplasty (ES) group and conventional septoplasty (CS) group of 50 patients each. The two groups were compared for technique, improvement in symptoms and complications. The postoperative symptoms and complications were significantly less in ES group due to better visualization and minimal dissection.

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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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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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