Conventional Septoplasty Research Articles

L-Strut Cartilage Graft: A Versatile Graft in Functional Rhinoplasty.

Anterior and high septal deviation can severely affect the functional and cosmetic outcomes of a patient. Conventional septoplasty would not be sufficient in these conditions to restore the functionality and aesthetics of a nose, and the majority of the patients require L-shaped grafts for the reconstruction of the septum. In the present study, we shared our experience in using an L-strut cartilage graft in functional rhinoplasty. It is a retrospective study of 60 patients who underwent septorhinoplasty from March 2020 to January 2023 using an L-strut cartilage graft for functional and aesthetic abnormality. The functional and aesthetic outcomes have been evaluated and compared before and 12months after the surgery. L-strut cartilage graft was used in 60 cases of functional rhinoplasty. There was a significant improvement in the functional and aesthetic outcomes in all the cases (p < 0.05). No significant intraoperative and postoperative complications were detected in any of the patients until 12months of follow-up. L-strut cartilage graft could be a versatile graft that can be successfully utilized in patients with gross anterior/dorsal septal deviation. It provides a stable, straight midline fixation of the neoseptum, ensuring good functional and aesthetic results without major complications.

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

Endoscopic septoplasty versus conventional septoplasty: a review article

Comparing endoscopic and traditional septoplasty in terms of operating time, functional efficacy, and perioperative morbidity was the goal of this study. Using the PubMed database, Google, and Google Scholar, a systematic assessment of the scientific literature was conducted. Randomized prospective trials comparing endoscopic and traditional septoplasty were sought after. Operating time was the major goal, while the secondary endpoints were hospital stay, functional outcome, intra- and postoperative complications, and postoperative discomfort. The comparison of endoscopic and traditional septoplasty was conducted in twenty-nine studies published between 1991 and 2012, five of which were prospective randomized trials. With endoscopic surgery, there was less mucosal damage (p &amp;lt; 0.01), less synechia (p &amp;lt; 0.01), less residual deformity (p &amp;lt; 0.05), and less pain following surgery. The operating duration was also shorter (p &amp;lt; 0.001). Thus, endoscopic septoplasty resulted in a shorter surgical duration and fewer postoperative problems; nonetheless, the functional outcome remained identical to that of conventional septoplasty.

Endoscopic Septoplasty vs Conventional Septoplasty: A Comparitive Study

Introduction: Nasal obstruction due to deviated nasal septum is a common problem encountered by most otolaryngologists. A variety of surgical procedures have been tried in the treatment of the same. Objective: This study was conducted to evaluate the outcomes and complications of endoscopic and conventional septoplasty and to compare both. Materials and Methods: This is a prospective, randomized study done in tertiary health center, Mangalore in which 60 patients with symptomatic deviated nasal septum were included in the study. Twenty two of them underwent conventional septoplasty and the remaining thirty eight underwent endoscopic septoplasty. Results: Endoscopic septoplasty had better outcome with respect to complications and proved as an easier method to correct posterior deviations and isolated spurs. Post operative symptoms were also better in the group which underwent endoscopic septoplasty. Conclusion: Endoscopic septoplasty allows accurate, conservative repair of obstructive nasal septum deviations, with fewer complications and better functional results compared to conventional septoplasty.

The Rate of Revision Septoplasty in Conventional and Endoscopic Approaches: A Retrospective Comparative Study

Abstract Background: Long-term outcomes of endoscopic septoplasty and conventional septoplasty are not well defined in the literature. Endoscopic septoplasty is a valuable alternative to the conventional approach and provides better visualization and illumination of the nasal septum. Objective: The objective of the study was to compare the revision rate between the conventional and endoscopic septoplasty approaches. Study Design: Retrospective chart review and cross-sectional questionnaire. The study was conducted in an academic tertiary center. Materials and Methods: Participants were patients who underwent conventional septoplasty and endoscopic septoplasty. Any subsequent revision septoplasty surgery over a period of at least 2 years of follow-up was documented. Results: A total of 261 patients (mean [±standard deviation] age: 30.00 ± 9.29 years) fulfilled the inclusion criteria, of whom 166 (63.6%) underwent conventional septoplasty and 95 (36.4%) underwent endoscopic septoplasty. Twelve (4.6%) patients underwent subsequent revision septoplasty: 11 (6.6%) in the conventional group and 1 (1.1%) in the endoscopic group (P = 0.039). The mean Nasal Obstruction Symptom Evaluation (NOSE) score was 31.42 ± 27.73 in the conventional group and 23.09 ± 24.11 in the endoscopic group (P = 0.018). Regarding patient satisfaction, 82 (56.9%) patients in the conventional group were satisfied compared with 75 (79%) in the endoscopic group (P &lt; 0.001). Conclusion: The rate of revision surgery after endoscopic septoplasty was lower than for the conventional approach on long-term follow-up.

Endoscopic septoplasty versus conventional septoplasty for nasal septum deviation: a systematic review and meta-analysis of randomized clinical trials.

The authors searched five electronic databases for relevant clinical trials. The records were screened for eligibility. Data were extracted from the included studies. Outcomes were pooled as risk ratios (RR) or mean differences with 95% CIs using RevMan ver.5.4. Our study included 13 randomized clinical trials with 735 patients. Our analysis revealed that endoscopic septoplasty was significantly (P<0.05) superior to conventional septoplasty for postoperative nasal obstruction relief, intraoperative and postoperative hemorrhage, and mucosal adhesion and synechiae across both long-term and short-term follow-ups. The following pooled RR values were found in short-term follow-up periods: [RR=1.20, 95% CI:=(1.09,1.32)]; [RR=0.27, 95% CI=(0.14,0.54)]; and [RR=0.16, 95% CI=(0.08,0.32)], respectively. Regarding persistent septal deviation and septal tear, endoscopic septoplasty had the upper hand only in short-term follow-up periods [RR=0.30, 95% CI=(0.17,0.53)] and [RR=0.26, 95% CI=(0.15,0.46)], respectively. Our analysis revealed that endoscopic septoplasty was significantly superior to conventional septoplasty in postoperative nasal obstruction relief rate and reducing the risk of intraoperative and postoperative hemorrhage, mucosal adhesion and synechiae, persistent septal deviation, septal tear, and surgery duration.

Comparative Study of Surgical Outcome in Endoscopic-Assisted Versus Conventional Septoplasty Using Nasal Surgical Questionnaire (NSQ): A Randomized Control Trial.

Deviated nasal septum (DNS) causes nasal obstruction, secretions, decreased sense of smell, bleeding, headache and snoring. This study aims to compare endoscopic-assisted septoplasty versus conventional septoplasty in terms of surgical outcome and intra-and post-operative complications. A prospective study was done on 50 patients aged between 18 and 41years of which, 41 (82%) cases were males and 9 (18%) were females who had DNS based on clinical examination and diagnostic nasal endoscopy. Patients were randomized by simple randomization into two groups. Functional outcome was assessed using nasal surgical questionnaire (NSQ) prior to and after surgery for 3months post-operatively and complications associated with the surgery were compared between two groups. In this study, most of the patients had anterior dislocations, present in 37 cases (74%). Improvement in pre- to post-operative visual analogue scale (VAS) for nasal obstruction was significantly better in endoscopic-assisted than conventional septoplasty (p < 0.001*). Pre-and post-operative differences in 4-point likert scale for other nasal symptoms like decreased sense of smell, snoring, secretions, headache and crusting were better in endoscopic-assisted septoplasty (p < 0.001*). Complications in endoscopic-assisted septoplasty were less common compared to conventional septoplasty (p = 0.05). In endoscopic-assisted septoplasty patients, pre-to post-operative NSQ (Nasal Surgical Questionnaire) VAS improvement for nasal obstruction, likert scale change from pre-to post-op were better and complications were lesser compared to conventional septoplasty. This suggests endoscopic-assisted septoplasty has better surgical outcomes and fewer complications and posterior deviations, spurs and inferior deviations can be corrected with ease and fewer complications.

The comparison of endoscopic septoplasty and conventional septoplasty: A PRISMA analysis

ObjectiveSeptoplasty is a surgical procedure to correct the deviated nasal septum (DNS). There are two main approaches to address septoplasty – conventional (CS) and endoscopic septoplasty (ES). This study is aimed to compare the perioperative complications following the two techniques, compare postoperative nasal obstruction between the two approaches, and assess the quality of the available evidence. MethodsA systematic literature search was carried out across multiple databases by independent investigators. We extracted relevant articles that compared conventional septoplasty to endoscopic septoplasty. Cochrane risk of bias tool (RoB2) and Newcastle Ottawa Scale (NOS) was used for the quality assessment of randomized and non-randomized studies, respectively. The objectives comprised immediate surgical complications, surgical length, postoperative nasal obstruction, and quality of life. We incorporated follow-up periods into the univariate meta-regression analyses. ResultsA total of 2055 patients from 28 studies were included in this study. The endoscopic technique showed significantly lower risks of surgical complications. No difference was found in surgical length (3 studies MD 6minutes [95%CI –25–14], P=0.57). Postoperative nasal obstruction was lower in ES but varies with the follow-up periods. Functional assessment scores using NOSE and quality of life were similar between the two approaches. Risk of bias assessment of the included studies showed an overall moderate- to high-risk of bias. ConclusionEndoscopic septoplasty demonstrates a lower risk of complications. Long-term benefits of nasal obstruction were likely similar in the two techniques. Further high quality of studies is still warranted, and conclusions should be taken with discretion given the low quality of the included studies in this present meta-analysis.

Surgical Outcomes of Endoscopic Versus Conventional Septoplasty.

The most common cause of nasal obstruction is a deviated nasal septum. It causes breathing difficulties and may eventually also cause sinusitis, epistaxis, sleep disturbances and snoring. The traditional surgeries of the nasal septum improve the nasal airway but do not fulfil the essential criteria in most instances. Endoscopic septoplasty is a fast-developing concept and gaining popularity as it provides a direct targeted approach to the septal anatomic deformity allowing a minimally invasive procedure under excellent visualization. The aim of this study is to compare the post-operative morbidity among conventional and endoscopic septoplasty. The present prospective study was conducted on 50 patients having deviated nasal septum. Patients were randomly divided into two groups of 25 each. Out of 50 patients, in 25 patients (Group A) Conventional septoplasty was done, whereas in other 25 patients (Group B) endoscopic septoplasty was done. The patients were followed up post-operatively at 2weeks, 4weeks and 8weeks. Study Design: comparative study. The mean of operating time (min) in Group A was 60.47 ± 8.16 which was significantly higher as compared to Group B (39.7 ± 6.73). (p value < .0001). The Mean of blood loss (mL) was significantly higher in Group A (88.67 ± 8.77) as compared to Group B. (54.6 ± 7.18). (p value < .0001). Post-operative NOSE score at one month was 7.33 ± 1.5 in group A which was significantly higher as compared to Group B (5 ± 1.41). (p value = 0.0007) whereas post-operative NOSE score at 3months in Group A was 6.53 ± 1.25 which was significantly higher as compared to Group B (4.4 ± 1.78). Proportion of post-operative complications was comparable in Group A and Group B (No complication 80% vs. 92% respectively). According to the present study, both the conventional and endoscopic septoplasty procedures were effective in relieving nasal obstruction in the patients. Endoscopic septoplasty showed significantly better result than conventional septoplasty in terms of time taken for surgery, blood loss during the surgery, post-operative complications and in terms of quality of life as assessed by NOSE Score.

Does final intraoperative endoscopic control increase surgical success in conventional septoplasty?

Objectives: This study aimed to investigate the effects of the final endoscopic control performed intraoperatively in conventional septoplasty on operative time, residual deviation, and changes in Nasal Obstruction and Septoplasty Effectiveness Scale (NOSE) scores. Patients and Methods: One hundred twenty-five patients who applied with the complaint of nasal obstruction between June 2020 and May 2021 and were found to have isolated nasal septum deviation were evaluated in this prospective study. Patients with comorbidities were excluded from the study. Remaining 80 patients (55 males, 25 females; mean age: 30.1±8.9 years; range, 18 to 58 years) included in this study. The patients were divided into two groups of 40 individuals using the blocked randomization method. In the first group (CS-EC group; 26 male, 14 female; mean age: 31.7±8.3 year; range 18 to 58 year), after conventional septoplasty with head light, additional pathologies were corrected with the conventional method if it was detected by the endoscope. For the second group (CS group; 29 male, 11 female; mean age: 28.6±9.3 year; range 18 to 53 year), only conventional septoplasty was performed. The patients were evaluated with NOSE before and three months after the operation to evaluate the complaint of nasal obstruction. The groups were compared in terms of NOSE scores, operation time, and postoperative residual deviation. Results: The mean operation times in the CS-EC and CS groups were 44.9±9.3 and 39.0±7.7 min, respectively, and this difference was statistically significant (p=0.001). While there was no statistically significant difference between the CS-EC and CS groups in terms of preoperative total NOSE scores (p=0.211), the postoperative total NOSE score was found to be statistically significantly lower in the CS-EC group compared to the CS group (p=0.001). Conclusion: Final intraoperative endoscopic control of the nasal passage in classical septoplasty may be an effective method to detect septal deviations that cannot be adequately evaluated.

Efficacy and safety of endoscopic septoplasty for treating nasal septal deviations compared with conventional septoplasty: A systematic review and meta-analysis.

We assessed the effects and safety of endoscopic septoplasty in patients with nasal septal deviations (NSD), compared with those of conventional septoplasty. Systematic review and meta-analysis. Patients who have undergone various endoscopic septoplasty procedure, such as hemitransfixion incision, incision at the deviated site and Killian incision, and conventional septoplasty. Six databases were searched up to April 2022. We analysed studies comparing improvements in NSD-related symptoms and post-operative complications between endoscopic septoplasty and control (conventional septoplasty) groups. A total of 38 articles with 2733 individuals were included. There were no significant differences in operative time (-0.4354, 95% confidence interval [CI: -1.1670; 0.2962]) or intra-operative bleeding (-1.3011 [-2.8003; 0.1981]) between the two groups. In the endoscopic septoplasty group, the change in nasal obstruction symptom evaluation score (9.5143 [5.4613; 13.5674] was statistically higher and the incidence of mucosal tearing (0.2766 [0.1889; 0.4049]) was lower. The incidences of full relief from symptoms such as headache (2.1996 [1.6896; 2.8634]), hyposmia (4.4468 [2.6806; 7.3767]), nasal obstruction (5.9871 [4.3292; 8.2800]), post-nasal drip (4.7241 [3.4086; 6.5472]) and snoring (2.9980 [1.2622; 7.1211]) were significantly higher in the endoscopic septoplasty group. In terms of post-operative endoscopic findings, epistaxis (0.3043 [0.1969; 0.4703]), hematoma (0.2022 [0.0785; 0.5213]), nasal obstruction 0.3373 [0.1334; 0.8527]), residual posterior septal deviation (0.1562 [0.0921; 0.2650]), septal perforation (0.2286 [0.1069; 0.4889]), residual spur (0.1294 [0.0602; 0.2780]) and synechia (0.2537 [0.1849; 0.3483]) were significantly less common in the endoscopic septoplasty group. Endoscopic septoplasty better relieved NSD-related symptoms and reduced surgery-related complications compared to conventional septoplasty.

Comparison of Endoscopic Versus Conventional Septoplasty in Jharkhand Population

Background: Although there are many techniques for septoplasty to cure nasal obstruction. Nasal endoscope is very useful tool to visualise posterior part of septum and perform the surgery more precisely, with less complication as compare to conventional method.Method: Out of 90 (Ninety) patients having DNS associated with epistaxis,chronic rhino sinusitis, snoring were studied 45 were treated with Endoscopic septoplastyand 45 with conventional septoplasty pros and cons of both tools and techniques were noted.Results: Post-surgical complications were least in Endoscopic surgery as compare to conventional septoplasty – 0% bleeding in Endoscopy and 2 (4.44%) in conventional, 7 (15.5%) DNS recurrence in conventional and 3 (6.66%) in endoscopic, 3 (6.6%) Epistaxis and crusting in conventional and 1 (2.2%) in Endoscopy and 0% crusting in Endoscopy.Conclusion: It is concluded that Endoscopic septoplasty is quite safer due to better illumination which enables to identify the pathology of septum precisely and realignment of the cartilages for better results

A STUDY OF CONVENTIONAL SEPTOPLASTY VERSUS ENDOSCOPIC SEPTOPLASTY

Introduction:Adeviated 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 postoperative results among patients of conventional and endoscopic septoplasty and to assess the efcacy 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 Patna Medical College &amp; Hospital , Patna for 12 months. Patients were selected by simple random sampling and were divided into Groups Aand B, with 20 patients in each group. Group A underwent conventional septoplasty and Group B underwent endoscopic septoplasty. Results: The male-tofemale ratio in the present study was 3:1. Deviated nasal septum was commonly associated with inferior turbinate hypertrophy (44%) and concha bullosa (28%). Postoperatively, a signicant relief from the symptoms of nasal obstruction (80%), nasal discharge (30%), 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 ap dissection and exposure.

A comparative study of the outcomes of endoscopic septoplasty with conventional septoplasty

Background Deviated nasal septum is common problem in otolaryngorhinological practice. This study was mainly undertaken to compare the advantages and disadvantages of endoscopic septoplasty over conventional septoplasty. Material and methods A prospective study was undertaken in 60 patients attending ENT OPD in a tertiary care centre. The sample was selected by using non-probability convenient sampling technique. Equal number of patients were randomly allocated in to endoscopy and conventional groups by double blinding method. Preoperative nasal obstruction symptom score was noted and intraoperative time was noted in minutes. Al the patients received pe medication and operated adhering to strict protocol. The patients were followed at weekly interval for complications and success rates. Results The mean age of the patients was 27 years and majority of the patients were males. Nasal blockage was the common symptom in the study group. The nasal airflow improved to 4 – 5 cm2 in patients of both the groups. The mean duration of the surgery was 60.37 minutes in endoscopic group and 54.07 minutes in conventional group. Unilateral mucosal tear was the common intraoperative complication and was seen more in conventional group than the endoscopic group.

Analogical Evaluation of Endoscopic Septoplasty in Posterior Septal Deviation

Background: Deviated Nasal Septum is one of the pronounced causes of Nasal Obstruction. A number of surgeries are being done since decades to alleviate symptoms. Recent advancement with endoscopes has revolutionized the surgical approach towards minimal invasive procedures. Aim: To analyze the post-op hospital stay and complications in headlight vs. endoscopic septoplasty Study design: The study is Cross sectional Randomized Control Trial. Place and duration of study: We conducted this study in ENT Unit I of Jinnah Hospital Lahore from June 2021 to January 2022. The follow up time was 2 months. Methodology: We performed this study on 30 patients who were diagnosed with Posterior Septal deviation. We randomly divided the patients into two groups. Group A was to undergo trans-nasal trans-speculum (TNTS) septoplasty while group B, endoscopic septoplasty. We analyzed the outcomes in the form of incidence of anterior nasal packing, post-op hospital stays and rate of adhesion formation. Results: We concluded that in Group A, nasal packing was required in 14(93.3%) patients, adhesion formation in 2(13.3%) patients and the mean post-operative hospital stay was 2.13±0.352 days while in Group B, only 3(20%) patients needed anterior nasal packing, none developed post-surgical adhesion formation and the mean postop hospital stay was 1.00±0.000 days. Practical implication: This study delineated that endoscopic septoplasty once mastered is far superior to Endonasal Conventional septoplasty and must be adopted in all public and private sectors to improve cost-effectiveness. Conclusion: We concluded that endoscopic septoplasty is far superior to trans-nasal trans-speculum (TNTS) septoplasty when post-op hospital stays and incidence of nasal packing was concerned in posterior septoplasty. However, there was no statistical difference in terms of post-surgical adhesion formation among the two studied groups. Keywords: Endoscopic Septoplasty, Trans-nasal trans-speculum (TNTS) septoplasty, Deviated Nasal Septum

Totally endoscopic versus conventional septoplasty assisted by endoscope

Totally endoscopic versus conventional septoplasty assisted by endoscope

A comparative study of endoscopic Septoplasty versus conventional Septoplasty

Nasal obstruction due to deviated nasal septum is a common problem encountered by otolaryngologists. A variety of surgical procedures have been tried in the treatment of the same. This study was conducted to evaluate the outcomes and complications of endoscopic and conventional septoplasty. This is a prospective, randomized study. Fifty patients with symptomatic deviated nasal septum were included in the study, 25 of them underwent conventional septoplasty and the rest underwent endoscopic septoplasty. The difference in the functional outcome of both the surgeries was insignificant. There was a significant difference with respect to complications. Endoscopic septoplasty had better outcome with respect to complications. It is easier to correct posterior deviations and isolated spurs with endoscopic septoplasty. Complications are lesser with endoscopic septoplasty.

Comparative Study of Endoscopic and Conventional Septoturbinoplasty in Patients with Nasal Airway Obstruction

Objectives: The goal of our study was to perform endoscopic septoplasty with or without turbinate reduction and also to determine its postoperative subjective and objective improvements. Methods: This was a hospital-based pre and post clinical trial study of 63 patients with nasal septal deviation treated with endoscopic and conventional septoplasty with or without turbinoplasty from 2013 to 2016. Nasal airway patency was recorded before and 2.7 months after surgical treatment using a visual analogue scale (VAS), Glatzel mirror test and bilateral peak nasal inspiratory flow (PNIF) measure. Results: Endoscopic (27 patients) and conventional septoturbinoplasty (36 patients) was performed on 63 patients (40 males; 23 females) with a mean age of 35 years. The results showed a significant improvement of nasal passage condition in scales of VAS, Glatzel mirror test, and bilateral PNIF values after surgery in both groups. In both surgical techniques septoplasty with turbinate reduction showed better improvement in VAS and bilateral PNIF scores than septoplasty alone. Conclusion: The application of endoscopic technology has an advantage of precise visualization and is a valuable tool especially when it is used for educational reasons. Subjective and objective improvements were confirmed equally in both endoscopic and conventional groups.

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

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)

Critical review of the literature on conventional septoplasty in children

Critical review of the literature on conventional septoplasty in children