Clinical and Radiological Evaluation of Deviated Nasal Septum in Classifying and Surgical Management of the Deviated Septums

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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Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00024-2 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Ashraf Ali El-Demerdash ◽

Essam Abdel Wanees Beheiry ◽

Sherif Maher El-Aini ◽

Asmaa Shams El-Dein Mohamed ◽

Ahmed Mohamed Ibrahim Khattab

Keyword(s):

Layer Thickness ◽

Nasal Septum ◽

Inferior Turbinate ◽

Military Hospital ◽

Deviated Nasal Septum ◽

Nasal Turbinate ◽

Egyptian Patients ◽

Mucosal Layer ◽

Group A ◽

Group B

Abstract Background The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients. Methods Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital. Results By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B. Conclusion The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.

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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.

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Rational for removal of every vestige of deviated nasal septum

The Laryngoscope ◽

10.1288/00005537-194809000-00007 ◽

1948 ◽

Vol 58 (9) ◽

pp. 1055-1066

Author(s):

E. Markey Pullen

Keyword(s):

Nasal Septum ◽

Deviated Nasal Septum

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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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