Advantages and Limitations of Endoscopic Septoplasty: Experience of 120 Cases

Md. Ashraful Islam; Tareq Mohammad; Nazmul Hossain Chowdhury; Towsif Bin Mamoo; Farid Uddin Milki; ASM Lutfur Rahman

doi:10.38124/ijisrt20jul216

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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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 endoscopic verses conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210507 ◽

2021 ◽

Vol 7 (3) ◽

pp. 417

Author(s):

Radeif Shamakhi ◽

Wael A. Juribi ◽

Ali H. Alzarei ◽

Musleh H. Mubaraki

Keyword(s):

Surgical Procedure ◽

Nasal Septum ◽

Conventional Technique ◽

Sinus Surgery ◽

Age Group ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Group A ◽

Group B ◽

Excellent Tool

Background: Septoplasty is the surgical procedure for the correction of a deviated nasal septum. It can be achieved either with an endoscopic or a conventional approach. Endoscope allows better visualization and magnification, helps in enhancing surgical procedure accuracy and there is also no need for overexposure, excessive septal anatomy manipulation, osseocartilaginous disarticulation of the nasal septum and further resection. Endoscopic septoplasty is not only used to address symptomatic nasal obstruction, but also to improve visualization in sinus surgery. This study was conducted to compare intra operative bleeding of the two techniques in treatment of deviated nasal septum.Methods: The present study was conducted in the department of otorhinolaryngology, Prince Mohammed hospital and Aseer central hospital. The study was conducted in 30 patients having symptomatic DNS, in the age group of 18-50 years after obtaining their consent. The patients were randomly divided into two groups of 15 patients each. Group A (n=15) underwent endoscopic septoplasty and group B (n=15) underwent conventional septoplasty under general anesthesia. The two groups were compared regarding intra operative bleeding of surgery.Results: In conventional septoplasty there is more bleeding during surgery but in Endoscopic septoplasty the bleeding is less during surgery.Conclusions: The endoscopic septoplasty offers an alternative to conventional technique with superior visualization, excellent illumination and excellent tool for teaching. It preferred for posterior deviation, whereas conventional septoplasty is still preferred for anterior deviation.

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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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Effect of Deviated Nasal Septum on Mean Platelet Volume: A Prospective Study

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-014-0748-9 ◽

2014 ◽

Vol 66 (4) ◽

pp. 437-440 ◽

Cited By ~ 3

Author(s):

Vijay Kumar Poorey ◽

Pooja Thakur

Keyword(s):

Prospective Study ◽

Mean Platelet Volume ◽

Nasal Septum ◽

Platelet Volume ◽

Deviated Nasal Septum ◽

A Prospective Study

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Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

10.53350/pjmhs211571860 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1860-1863

Author(s):

Bakht Zada ◽

Ejaz Ahmed ◽

Muhammad Habib ◽

Zafar Iqbal ◽

Rehan Saleem ◽

...

Keyword(s):

Risk Factors ◽

Nasal Septum ◽

Nasal Polyps ◽

Bone Erosion ◽

Histopathological Examination ◽

Sinus Surgery ◽

Fungal Sinusitis ◽

Deviated Nasal Septum ◽

Allergic Fungal Sinusitis ◽

Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

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Radiological significance of the sinonasal anatomical variants in recurrent acute rhinosinusitis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172121 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2379

Author(s):

Niranjan Sahu ◽

Satya Sundar G. Mohapatra ◽

Siba N. Rath ◽

Rabindra N. Padhy

Keyword(s):

Nasal Septum ◽

Middle Turbinate ◽

Uncinate Process ◽

Sinus Surgery ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Anatomical Variants ◽

Acute Rhinosinusitis ◽

Computed Tomography Images ◽

Osteomeatal Complex

Background: Recurrent acute rhinosinusitis (RARS), a low form chronic rhinosinusitis is frequently under evaluated. The significance of sinonasal anatomical variants of osteomeatal complex (OMC) and spheno-ethmoidal (SE) recess regions in patients of RARS is assessed.Methods: Retrospective analysis of coronal sinonasal computed tomography images of 120 RARS patients presented with sinonasal anatomical variants during November 2013 to October 2016 was carried out. Patients with acute and expansile sinonasal lesions are excluded.Results: Sinonasal anatomical variants in the regions of OMC and SE recess are responsible for obstruction of normal mucociliary drainage of corresponding paranasal sinuses in presence of inflammation predisposing to RARS. Anatomical variants of nasal septum were, deviated nasal septum (DNS) in 86 (72%) and septal spur in 58 (48%) patients. Anatomical variants in OMC region were, pneumatized middle turbinate (concha bullosa) in 50 (48%), paradoxical middle turbinate in 38 (28%), giant ethmoid bulla in 35 (32%), agger nasi cell in 29 (38%), Haller cell in 23 (15%), pneumatised uncinate process in 20 (18%), medialized uncinate process in 18 (22%) and septated maxillary sinus in 5 (4%) patients. Anatomical variants in SE recess were superior concha bullosa in 14 (12%) and septal bullosa in 11 (9%) patients.Conclusions: OMC pattern of recurrent rhinosinusitis is often prevalent in patients of RARS due to abundance of anatomical variants in the OMC region. DNS or ethmoid bulla when gets associated with concha bullosa increased the incidence of RARS. Present analysis would help surgeons to evaluate RARS patients for selective endoscopic sinus surgery.

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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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Anatomical variations in patients with chronic sinusitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180702 ◽

2018 ◽

Vol 4 (2) ◽

pp. 428 ◽

Cited By ~ 1

Author(s):

Pragadeeswaran Kumarasekaran ◽

Rajprakash Dharmapuri Yadhava krishnan ◽

Gurumani Sriraman

Keyword(s):

Nasal Septum ◽

Chronic Sinusitis ◽

Anatomical Variation ◽

Middle Turbinate ◽

Anatomical Variations ◽

Uncinate Process ◽

Sinus Surgery ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Anatomical Variant

Background: Chronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. Methods: Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed. Results: In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. Conclusions: In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process. Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.

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