Limited Septoplasty Research Articles

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)

The role of limited septoplasty during functional endoscopic sinus surgery for chronic rhinosinusitis

Functional endoscopic sinus surgery (FESS) has been the most common surgery for chronic rhinosinusitis (CRS), and to accomplish surgical goals such as facilitate adequate visualization and allow room for endoscopic instrumentation, the correction of the minimally deviated septum has been advocated. Objective: To ascertain the role of limited septoplasty during functional endoscopic sinus surgery (FESS) in reducing the recurrence of the rhinosinusitis. Patients and methods:A prospective descriptive study conducted at the department of Otorhinolaryngology–Head & Neck surgery (Sulaymaniyah Teaching Hospital - College of Medicine - University of Sulaymaniyah). Patients were presented with refractory CRS, with concomitant septal deviation, and prepared for FESS were randomly divided into two groups; group A (10 patients) underwent FESS without septoplasty and group B (10 patients) underwent FESS with limited septoplasty. To determine the effectiveness of the septoplasty in concomitant with FESS, a comparison of the outcomes of FESS in both groups been done throughout utilizing the Sino-Nasal outcome test (SNOT-22) and Lund –Kennedy (LK) endoscopic score preoperatively and 6 months postoperatively. Results: Among the twenty patients included in this study, (40%) of patients in the group A and (30%) of patients in the group B had polyp extending to nasal cavity with (two score), which diminished to 0% at 6 months postoperatively. Need to blow nose, Sneezing, Runny nose, cough, postnasal discharge, ear fullness, dizziness, ear pain, facial pain/pressure, fatigue, sad, embarrassed symptoms had improved in patients undergone FESS with limited septoplasty. Conclusions: Limited septoplasty is primarily used when the septal deviation is located opposite the work area for endoscopic sinus surgery--namely, opposite the middle turbinate and/or the osteomeatal unit.

Nasal Fractures: The Role of Primary Reduction and Secondary Revision.

The nasal bones are among the most commonly fractured bones in the facial skeleton. Proper management of nasal trauma acutely is important in minimizing secondary deformities and impaired function with nasal airway obstruction. Septal hematoma, if present, should be drained right away. Acutely closed nasal reduction and limited septoplasty can be performed. Unrecognized septal fracture may play a role in the failure of closed nasal reduction of fractured nasal bones. Complex nasoorbitoethmoid fractures are approached openly and treated with rigid fixation. Primary use of open rhinoplasty in an acute setting is debated, and there are no clearly accepted indications for timing, patient selection, and surgical technique. However, open septorhinoplasty is more commonly used in a delayed fashion to provide definitive correction of any residual cosmetic or functional problems. Recent algorithms provide a systematic approach to nasal trauma and may improve secondary deformity rates following closed reduction.

Endoscopic surgery in pediatric recurrent antrochoanal polyp, rule of wide ostium

Objective To evaluate the use of wide middle meatal antrostomy in recurrent antrochoanal polyp (ACP) in children as regard technical difficulty, efficacy, and safety in children. Study design Retrospective study. Patients and methods In a retrospective study, 12 children with unilateral recurrent ACP (5 left-sided, 7 right-sided). All the ACPs were documented by preoperative endoscopy and computer tomographic (CT) scans. All cases were treated using endoscopic wide middle meatal antrostomy. The average age at the onset of symptoms was 9.3 years (median age: 10 years; range: 6–15 years). Results Postoperative improvement in all cases was achieved using both subjective measures (symptoms improvement) and objective measures (radiological and endoscopical). No postoperative complications or recurrence during the follow up period. Conclusions Endoscopic wide middle meatal antrostomy is a useful and easily applicable technique to manage recurrent antrochoanal 3 polyp in children. Managing associated pathology as turbinate hypertrophy, associated adenoids, anterior ethmoidectomy, uncinectomy and endoscopic limited septoplasty should be put in mind in order to improve ventilations. Powered instrumentations, angled endoscopes (45 and 70°) and angled instrumentations can assure complete clearance of the polyp by identifying the origin of polyp in maxillary antrum.

Endoskopowe leczenie chorych z zapaleniami zatok przynosowych i współistniejącymi anatomicznymi zaburzeniami drożności nosa

The aim of the study was to evaluate the frequency of co-occurrence of anatomic disorders within the nasal area in patients suffering from chronic paranasal sinusitis. Between 2006-2008 there were 446 endoscopic operations performed on patients with chronic paranasal sinusitis. Apart from paranasal sinuses surgeries, 172 patients underwent an additional operation on anatomic deviations within the nasal area. The study group included 98 women and 74 men. First, the nasal septoplasty was performed in a typical way according to the Cottle's principles with the use of endoscope, which was followed by functional endoscopic operations on paranasal sinuses. The middle concha bullosa operations were performed by opening the pneumatisized bony part and removing the lateral part. Among 446 patients who underwent endoscopic treatment due to chronic paranasal sinusitis substantial anatomic disorders were found in 38.6% of the cases qualifying the patients for further surgical procedures. Simultaneously, bilateral plasties of the middle concha bullosa were conducted in 25.1% of the cases whereas 10.3% of the patients underwent lateral operations on the middle concha bullosa. In the studied group the septoplasty was performed in 37.4% of the cases. Rarely unilaterally, with the use of endoscope, we removed spines or ledges from the nasal septum in 19.5% and 7.7% of the cases respectively. Moreover, 14 patients underwent operations on the nasal septum and middle concha bullosa at the same time. The co-occurrence of the spine in the nasal septum and middle concha bullosa was found in 6 operated patients. Bilateral middle concha bullosa and nasal septum ledge were operated three times. The anatomic causes of disorders in nasal patency were frequently found in the studied material. Thus, it proves their substantial part in patomechanism of paranasal sinusitis. Correcting anatomical anomalies ought to be performed simultenously with the operation within the paranasal sinuses. Endoscopically controlled limited septoplasty is a crucial element of complex surgical approach in the paranasal sinusitis.

Endoscopic limited septoplasty in combination with sinonasal surgery.

The systematic use of fiberoptic techniques in the sinonasal region has made it possible to assess the nasal septum with more precision. The presence of limited septal deviation or isolated septal spurs can cause airway obstruction in the sinuses or impede the execution of endoscopic sinonasal procedures for a disorder not related to the morphology of the nasal septum. This study assesses the indications, surgical technique, and results in 170 patients who underwent endoscopic limited septoplasty performed concomitantly with endoscopic sinonasal surgery.

Limited septoplasty for endoscopic sinus surgery

Septoplasty, in its myriad forms, has been used for decades as a treatment to correct nasal airway obstruction. In some cases septoplasty is done to achieve adequate visualization for further work on the nose or paranasal area. With the onset of FESS the correction of the deviated septum has increasingly been done to facilitate adequate visualization and to allow room for endoscopic instrumentation. Limited septoplasty incorporates parts of both classic nasal septal reconstruction (or Cottle septoplasty) and submucous resection of the septum. Limited septoplasty is primarily used when there is a specific deviation of the septum that limits the ability of the surgeon to accomplish surgical goals-namely, adequate visualization of the surgical field during surgery and during postoperative care. Decreased nasal obstruction is only a secondary consideration for limited septoplasty.

Limited septoplasty for endoscopic sinus surgery.

Septoplasty, in its myriad forms, has been used for decades as a treatment to correct nasal airway obstruction. In some cases septoplasty is done to achieve adequate visualization for further work on the nose or paranasal area. With the onset of FESS the correction of the deviated septum has increasingly been done to facilitate adequate visualization and to allow room for endoscopic instrumentation. Limited septoplasty incorporates parts of both classic nasal septal reconstruction (or Cottle septoplasty) and submucous resection of the septum. Limited septoplasty is primarily used when there is a specific deviation of the septum that limits the ability of the surgeon to accomplish surgical goals-namely, adequate visualization of the surgical field during surgery and during postoperative care. Decreased nasal obstruction is only a secondary consideration for limited septoplasty.

Neonatal septoplasty: case report and review of the literature

Treatment of nasal septal deformity in childhood has received growing acceptance in recent years. Traditionally, concern about the role of the septum in the overall growth of the midface has led otolaryngologists to take a very cautious approach to correction of septal deformities in children. However, a great deal of evidence now suggests that severe traumatic septal deviation can and should be corrected early in childhood to prevent future nasal and systemic complications. Closed manipulation of the septum in the first 1–2 days of an infant's life has been performed by many otolaryngologists with good results. The use of this technique, however, is usually limited to those subluxations of anterior cartilage which are diagnosed immediately or very shortly after birth. We present a case of severe traumatic nasal deformity presenting with obstructive asleep and awake apnea and cyanosis at the age of 8 days. The child underwent limited septoplasty using endoscopic techniques at age 14 days with resolution of both the apneic and cyanotic episodes immediately post-operatively. This unusual presentation and the literature surrounding infant nasal/septal surgery are discussed.

Limited septoplasty as treatment for recurrent epistaxis in a child with glanzmann's thrombasthenia

Recurrent epistaxis can be a serious problem in children with coagulation disorders. We present a case of severe, recurrent nosebleeds in a 3-year-10-month-old boy with Glanzmann's thrombasthenia. The nature of Glanzmann's disease and medical treatment of epistaxis in children is reviewed. A method of controlling recurrent epistaxis with a very simple and limited septoplasty is described. This technique should be applicable to patients with recurrent nosebleeds and other more common coagulation disorders.