Endoscopic Versus Conventionanl Septoplasty: Our Institutional Experience

Abstract

Purpose: To assess advantages and disadvantages of endoscopic septoplasty and to compare post-operative results and complications of endoscopic with conventional septoplasty. Materials and Methods: A total of 50 (fifty) patients with symptomatic deviated nasal septum were prospectively studied. Patients were divided into two equal groups. One group underwent endoscopic septoplasty and the other group underwent traditional septoplasty under general anaesthesia. A detailed history and thorough examinations were carried out on all selected patients, using a pre-designed proforma. Subjective and objective assessments were done both pre- and post-operatively. Patients were followed upto three months post-operatively. Comparisons were made for relief of symptoms of nasal obstruction, headache, recurrent rhinorrhoea,hyposmia and post nasal drip after the surgery in both the groups under study and also postoperative complaints like haemorrhage, facial swelling, nasal pain and duration of hospital stay in both the study groups. Appropriate statistical tools were used for analysis of datas. Results: In the study, there were 38 males (76%) and 12 females (24%). The most commonly affected subjects belonged to the 2nd and 3rd decade of life. The mean age was 28.00yrs with a Std. Deviation ± 8.64. In the study subjects, the most common pre-operative complaint was nasal obstruction (86%) followed by anterior nasal discharge (52%), headache (36 %), post nasal drip (44%) and hyposmia (14%). Subjectively 90% of patients who underwent endoscopic septoplasty (ES) and 82.60% of those who underwent traditional septoplasty (TS) were relieved of nasal obstruction while headache was relieved in 87.50 % of ES group and 60% of TS group. Rhinorrhoea, postnasal drip and hyposmia were relieved in 75%, 80% and 66.66% of ES group respectively, while these were relieved in 85.71%, 75% and 50% of TS group. The differences of symptomatic relief in both groups were statistically not significant (p> 0.05).Immediate complications like nasal bleeding, nasal pain, facial swelling and septal perforation following surgery were higher in traditional septoplasty group, but these were not statistically significant (p>0.05). Patients who underwent traditional septoplasty had longer hospital stay (>48 hrs) as compared to those who underwent endoscopic septoplasty (p 0.05).However, there was statistically significant residual posterior deviation and persistent spur between the groups (p<0.05). Synechia developed in 5(20%) of traditional group and none in endoscopic group, which was significant(p<0.05). Similar results were found during objective assessment at 03 month postoperatively.