Peri and Postoperative Compli-cations of Endoscopic Posterior Limited Septoplasty Versus Con-ventional Method Septoplasty in Endoscopic Nasal Surgery

Abstract

Background: A significant percentage of patients undergone endoscop-ic sinus surgery has septal deviation, that disturb adequate access to the osteomeatal complex or to the region of axilla of the middle turbinate. The good exposure is the most important key to a successful surgery. Straightening such a deflection improve the access to the work site on the lateral wall of the nasal cavity. Objective: To compare the peri and post operative complications be-tween conventional septoplasty (cottle's method) and the endoscopic posterior limited septoplasty in endoscopic sinus surgery. Patients and Methods: Forty patients (all of them had a limited posterior nasal septal deviation ,nasal and paranasal sinus pathology in addition to septal deformity),were selected and divided randomly into two equal groups, (by the type of surgery for septal correction. group A which underwent conventional (Cottle's septoplasty), while group B that had endoscopic type septoplasty). All patients were assessed in the otolaryn-gology department in AL- Immamain Al khadimain medical city, from October 2016 to November 2017.patients were evaluated pre and post operatively by clinical and endoscopical examination, and followed in a period of 1week, 1month and 3months post operatively. Results: Functional endoscopic sinus surgery was the most primary sur-gery done, followed by Dacrocystorhinostomy and Endoscopic spheno-palatine artery ligation .Most common intraoperative complication was mucosal flap tear which observed more in conventional group, .Regarding mean operative time for limited septoplasty it was shorter in endoscopic group .Synechia and delay wound healing as a post opera-tive complication was more in endoscopic group, while hematoma and perforation was more in conventional group. Conclusion: During endoscopic sinus surgery, limited posterior septal deviation can be corrected by endoscopic method which provides better direct visualization of the deviation, more conservative surgical manipu-lation, shorter in time and less intra and post-operative complications. Keywords: Functional Endoscopic Sinus Surgery( FESS), Dacrocysto-rhinostomy (DCR), ostiomeatal complex(OMC), deviated nasal sep-tum(DNS)