Complications of the surgery for deviated nasal septum.

Abstract

To find out the causes of complications arising due to nasal septal corrective surgery. Descriptive study. The study was carried out at the Department of Otorhinolaryngology, Head and Neck Surgery, Civil Hospital, Karachi, from 1997-1999. A total of 200 cases from all age groups of both genders with symptomatic deviated nasal septum (DNS) without allergic rhinitis were selected. One hundred sixty-two patients were males and 38 were females. All of them were subjected to nasal septal surgery as per situation. Septoplasty was performed in patients below 15 years of age with caudal septal dislocation and adults with minimal deviation confined to cartilagenous septum. Classical submucous resection (SMR) was performed in most other cases. A record was maintained in the outpatient Clinic in which the observations and findings of these patients, visiting for follow-up were entered for more than a year. SMR alone was performed in 96 cases (48%). SMR with bilateral antral washout in 35 cases (17%). SMR with submucosal diathermy and without fracture of inferior turbinate was done in 4 cases each (2%). Conservative septal surgery (septoplasty) was performed in 48 cases (24%). Septorhinoplasty was carried out in 13 cases (6.5%) with external nasal deformity due to severe deflection of nasal septum. In 50 cases (25%) intranasal splints were kept after the nasal septal surgery. The results of the surgical procedures were assessed clinically. The overall incidence of complications was septal perforation in 10 cases (5%), adhesions in 14 cases (7%), recurrence of symptoms or deformity in 12 cases (6%), saddle nose deformity in 2 cases (1%), and columellar retraction with loss of tip projection was found in 2 cases (1%). Palatal perforation was also observed in 2 patients which was repaired primarily and excellent healing occurred postoperatively. The incidence of complications was 21% and it was higher in classical submucosal resection than after septoplasty. Complications are related to the type of procedure performed. More complications are seen with classical SMR. Adhesions are common complication if intranasal splint is not provided.