AYURVEDIC MANAGEMENT OF DEVIATED NASAL SEPTUM – A CASE STUDY

Nasa Pratinaha is one among the 31 Nasa Roga in which nasal obstruction is the main symptom. It is a commonly encountered disease in clinical practice. This disease occurs due to aggravation of Udan Vata, enveloped with Kapha, thereby causing obstruction in nose. In contemporary science this disease can be co-related with many disorders like turbinate hypertrophy, deviated nasal septum, nasal polyp, tumours, allergic rhinitis and others; among which deviated nasal septum is a common cause. Deviated Nasal Septum can be treated with surgical and medical methods. The medical and surgical managements have their own limitations, merits, and demerits like synechiae formation, rhinitis sicca, severe bleeding, septal perforation, septal heamatoma, septal abscess etc. In Ayurvedic classics the treatment for Nasa Pratinaha is Snehapana, Nasya, Dhoompana etc. The best prescribed in Nasya Pratinaha for Nasya is Bala Taila, the same oil is also recommended for Nasa Pichu. Thus, this study was carried out with the objective of to evaluate the effectiveness of Bala Taila Nasya and Nasa Pichu in the management of Deviated Nasal Septum Nasal Septum. A case report of 43-year-old female who presented with complaints of frequent nasal obstruction, nasal discharge, discomfort in nose, and headache; was diagnosed with Deviated Nasal Septum. The patient was treated with Bala Taila nasya and Nasa Pichu with the same oil. Hence Bala Taila administered as Nasya and Nasa Pichu was significant in controlling the symptoms of Nasa Pratinaha (Deviated Nasal septum) without recurrence in the follow up period.

Download Full-text

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.

Download Full-text

A comparative study on the surgical outcome of submucous resection and septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203561 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1623

Author(s):

G. Agaman ◽

Nowfal A. Kabeer

Keyword(s):

Nasal Obstruction ◽

Surgical Outcome ◽

Nasal Septum ◽

Symptom Relief ◽

Treatment Protocol ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Mucosal Resection ◽

Postnasal Drip ◽

Submucous Resection

Introduction: Surgery on a deviated septum has seen several modifications since its inception, starting from radical septal resection to the preservation of the possible septal framework. Deviated nasal septum (DNS) leads to nasal obstruction is a common problem encountered by the Otolaryngologist. Many surgeries are available for correcting septal disorders. The aim of our study is to compare the surgical outcome of submucous resection and septoplasty.Methods: This prospective comparative single institutional interventional study was conducted in the department of otorhinolaryngology, Aarupadai Veedu Medical College between October 2015 to September 2017 to compare the submucous resection and septoplasty. Total of 50 patients who randomly divided into two groups and the treatment protocol and follow up protocol was followed and the outcome results were statistically analysed and discussed.Results: Out of 50 patients 25 patients had sub mucosal resection and 25 patients had septoplasty. All the 50 patients had nasal obstruction followed by headache present 35 patients, nasal discharge in 6 patients, postnasal drip in 7 patients and hyposmia in 7 patients. Based on endoscopy finding c shaped DNS 43 patients, 7 patients had s-shaped DNS, 7 patients had spur. Based on postoperative symptoms, the nasal block was present in 3 patients.Conclusion: From this study, we concluded that deviated nasal septum is more common in females of age group 30 years with the most common symptoms is nasal obstruction. Symptom relief is comparatively equal in both the surgeries but the complication is more common in sub mucosal resection.

Download Full-text

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.

Download Full-text

Role of Bilateral Inferior Turbinoplasty as an Adjunct to Septoplasty in Improving Nasal Obstruction and Subjective Performance in Patients With Deviated Nasal Septum Associated With Allergic Rhinitis: An Interventional, Prospective Study

Ear Nose & Throat Journal ◽

10.1177/01455613211015440 ◽

2021 ◽

pp. 014556132110154

Author(s):

Sanjoy Kumar Ghosh ◽

Mainak Dutta ◽

Dibakar Haldar

Keyword(s):

Allergic Rhinitis ◽

Prospective Study ◽

Nasal Obstruction ◽

Nasal Septum ◽

Inferior Turbinate ◽

Significant Benefit ◽

Rank Test ◽

Performance Parameters ◽

Deviated Nasal Septum

Background: Patients with nasal obstruction due to deviated nasal septum (DNS) often have allergic rhinitis (AR) as contributing factor. When optimal medical therapy for AR fails, septoplasty alone may not adequately treat nasal obstruction. Therefore, with bilateral inferior turbinate hypertrophy representing long-standing AR, adding bilateral inferior turbinoplasty (BIT) to septoplasty might be beneficial. Objective: To assess whether septoplasty with/without BIT alleviates nasal obstruction in the above patient cohort and whether adding BIT to septoplasty brings significant benefit. Methodology: In this interventional, prospective study, patients with nasal obstruction due to DNS and persistent, moderate-severe AR refractory to optimal medication were randomly allocated into group A (septoplasty alone) and group B (septoplasty with BIT). Nasal Obstruction and Symptom Evaluation (NOSE) score, along with Subjective Performance parameters (days-off/month; number of outdoor visits/month; overall satisfaction score [OSS]) were used to assess the symptom and quality of life, respectively, at follow-up. Results: Each group had 40 age/sex-matched patients. Friedman test, and subsequent pair-wise comparison within groups without Bonferroni correction, revealed that septoplasty with/without BIT elicited significant reduction in NOSE scores and in the Subjective Performance parameters (days-off/month; number of outdoor visits/month) at 3 and 6 months. Wilcoxon Signed Rank test revealed that the OSS within groups also improved significantly with time. Further, comparison between groups revealed significant improvement in NOSE scores at all levels of follow-up when BIT was included. However, there were no significant differences between groups in the Subjective Performance parameters at any level of follow-up. Improvement in OSS between groups was significant only at 3 months but not subsequently. Conclusion: Septoplasty with/without BIT is helpful in treating patients with DNS and refractory AR. However, although adding BIT brings significant benefit in decreasing nasal obstruction, it does not significantly improve the Subjective Performance parameters during follow-up, except for OSS at the third month.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

A Study on Clinical Profile of Deviated Nasal Septum and to determine the Efficacy of the Surgery

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1311 ◽

2017 ◽

Vol 10 (2) ◽

pp. 70-73

Author(s):

Mohan Mogarnad ◽

Vandana Mohta

Keyword(s):

Nasal Septum ◽

Clinical History ◽

Likert Scale ◽

Clinical Profile ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Medical College ◽

Subjective Scale ◽

Septal Surgery ◽

Detailed Clinical History

ABSTRACT Aim To study the clinical profile of deviated nasal septum and to assess the subjective efficacy of the surgical outcome using Likert scale. Materials and methods This study is a prospective, observational, single-center study from October 2013 to May 2015. The study was conducted in Sri Siddhartha Medical College, Tumkur, Karnataka, India. A detailed clinical history was taken and clinical examination of the patient was carried out. Sixty symptomatic patients were taken up. Patient scored their symptom-related severity using a Likert scale preoperatively. All patients underwent conventional septoplasty. Postoperatively, their symptoms were scored on 30th, 45th, and 90th day. Results Preoperative and Postoperative values were analyzed. Statistically significant improvement was observed in the entire population: Nasal obstruction (p<0.001), headache (p<0.001), nasal discharge (p<0.001), facial pain (p<0.001), and hyposmia (p<0.001). Patient satisfaction was high and they used fewer nasal medications. Conclusion After surgical correction of the septum and analysis of the subjective scale, i.e., Likert scale showed improvement in all symptoms. The principal benefits of septal surgery relate to improvement in nasal symptoms. How to cite this article Mogarnad M, Mohta V. A Study on Clinical Profile of Deviated Nasal Septum and to determine the Efficacy of the Surgery. Clin Rhinol An Int J 2017;10(2):70-73.

Download Full-text

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.

Download Full-text