Septal Deviation Research Articles

Association between nasal septum deviation and transverse maxillary development: A retrospective cross-sectional study

The few studies investigating the relationship between nasal septum deviation (NSD) and maxillary development, using different assessment methods and the age of subjects, reported contradicting results. The association between NSD and transverse maxillary parameters was analyzed using 141 preorthodontic full-skull cone-beam computed tomography scans (mean age, 27.4 ± 9.01 years). Six maxillary, 2 nasal, and 3 dentoalveolar landmarks were measured. The intraclass correlation coefficient was used to assess intrarater and interrater reliability. The correlation between NSD and transverse maxillary parameters was analyzed using the Pearson correlation coefficient. Each transverse maxillary parameter was compared among 3 groups of different degrees of severity using the analysis of variance test. Transverse maxillary parameters were also compared between the more and less deviated nasal septum sides using the independent t test. A correlation between deviated septal width and palatal arch depth (r= 0.2, P<0.013) and significant differences in palatal arch depth (P<0.05) among 3 NSD severity groups classified with deviated septal width was noted. There was no correlation between septal deviated angle and transverse maxillary parameters and no significant difference for transverse maxillary parameters among the 3 groups of NSD severity classified by septal deviated angle. No significant difference in transverse maxillary parameters was found when comparing the more and the less deviated sides. This study suggests that NSD can affect palatal vault morphology. The magnitude of NSD may be a factor associated with transverse maxillary growth disturbance.

Double Opposing U Suture For Septal Multiple Axis Deviations: A Multi-Vectoral Approach.

Septal cartilage deviations comprise the majority of deformities related to revision rhinoplasty operations. Therefore, the primary operation should be as eventless and durable as possible. Many techniques have been suggested, but most present with a monoplanar correction and fixation of the septum. This study aims to demonstrate a suture method that fixates and broadens the deviated septum. This method employs a single-stranded suture passing below the spinal periosteum, pulling the posterior and anterior portions of the septal base separately. It was utilized in 1578 patients, of which only 36 necessitated a revision of septoplasty in the past 11 years (2010-2021). With a revision rate of 2.29%, this method should be considered a preferable choice over many techniques described in the literature.

Dupilumab in complex therapy for chronic rhinosinusitis with nasal polyps and asthma

Chronic Rhinosinusitis with Nasal Polyps (CRwNP) caused by T2 inflammation has a complex pathogenesis, for which treatment options include medical therapy (topical and systemic glucocorticosteroids, leuktriene inhibitors, etc.) and surgical therapy, often recurs and significantly reduces the quality of life for patients. Chronic rhinosinusitis with nasal polyps is common in patients with asthma and, particularly, severe asthma and an allergic reaction to nonsteroidal anti-inflammatory drugs. These conditions are in most cases associated with a common pathogenesis, including a type II immune response, hyperproduction of interleukins (IL) 4, 5 and 13, activation of eosinophils and tissue remodeling. Biological therapy which block the effect of IL-4, 5, 13 can significantly improve the condition of such patients. Dupilumab is a humanized IgG4 monoclonal antibody that targets the IL-4 receptor alpha chain (IL-4Rα), thereby blocking the action of IL-4 and IL-13. Currently, dupilumab is approved for asthma, CRwNP and atopic dermatitis. Dupilumab can reduce the number of exacerbations, treatment with systemic corticosteroids, improve the condition of the upper and lower respiratory tract and achieve an increase in FEV1 by 0.2–0.3 L, which leads to a significant control of these diseases. One of the topical issues is the choice of tactics choice of treatment tactics in patients with CRwNP, asthma and nasal septum deviation. This article presents a clinical case of a patient with severe asthma, CRwNP and deviated nasal septum receiving dupilumab for 4 months.

Left Ventricular Outflow Obstruction in D-Transposition of Great Arteries: A Rare Etiology

A 2-day old neonate [gender: male; weight: 3.2 kg; height: 53cm] presented to the authors institution with an arterial oxygen saturation of 74%. The child was receiving 6 cm H2O continuous positive airway pressure therapy [FIO2: 0.5] and was treated with a prostaglandin E1 infusion [10ng/kg/min]. Transthoracic echocardiography revealed situs solitus, levocardia, normal systemic and pulmonary venous drainage and a 6 mm non-restrictive atrial septal defect with a left to right shunt. The atrioventricular connections were concordant. The aorta was arising from the right ventricle with no right ventricular outflow obstruction [Figure 1]. The pulmonary artery was arising from the left ventricle with confluent good size branch pulmonary arteries with posterior deviation of the conal septum [Figure 2]. A large perimembranous (conoventricular type)1 ventricular septal defect with an inlet [6 mm] and outlet [6 mm] extension and an additional tiny apical defect were demonstrated [Figure 3]. A patent ductus arteriosus [2.7 mm] shunting left to right was also present (not shown). A 2-dimensional echocardiography image in the parasternal long axis view displayed an obstruction to the left ventricular outflow tract [white arrow] and a color Doppler blood flow map demonstrated turbulence in the outflow tract [Figure 4A,B]. In the subcostal view with the probe tilted anteriorly, color flow Doppler mapping showed the ventricular septal defect and also the blood flow acceleration across the left ventricular outflow tract [Figure 5, videolip-1]. At the area of turbulence, the jet width was 0.234 cm[Figure 6A]. A continuous wave Doppler interrogation of the area demonstrated a gradient of ≈ 25 mmHg [Figure 6B]. 2-dimensional transthoracic echocardiography interrogation in the subcostal view identified the etiology of the left ventricular outflow tract obstruction [Figure 7, Videoclip-2]. What is the diagnosis? Figure 2Transthoracic echocardiography image showing the relationship between the pulmonary artery and the left ventricle. View Large Image Figure Viewer Download Hi-res image Figure 3Subcostal 4-chamber transthoracic echocardiography image showing the perimembranous ventricular septal defect. View Large Image Figure Viewer Download Hi-res image Figure 4A&B. Parasternal long axis transthoracic echocardiography 2-dimensional image showing the obstruction in the left ventricular outflow tract ‘white arrow’ [A], and turbulence in the outflow tract by a color Doppler blood flow map ‘white arrow’[B]. View Large Image Figure Viewer Download Hi-res image Figure 5Subcostal transthoracic echocardiography image showing color Doppler flow acceleration over the left ventricular outflow tract and a ventricular septal defect. View Large Image Figure Viewer Download Hi-res image Figure 6A&B. Subcostal transthoracic echocardiography image showing the width of the obstruction [A] and the pressure gradient across the obstruction [B]. View Large Image Figure Viewer Download Hi-res image Figure 7A subcostal transthoracic echocardiography view showing the etiology of the left ventricular outflow tract obstruction in systole. View Large Image Figure Viewer Download Hi-res image

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.

L-Strut Division Technique for Correction of Anterocaudal Septal Deviation: Functional and Cosmetic Outcomes.

Facial Plastic Surgery & Aesthetic MedicineAhead of Print L-Strut Division Technique for Correction of Anterocaudal Septal Deviation: Functional and Cosmetic OutcomesSonam Dodhia, Ade Obayemi, Kevin Kuonqui, and Oscar TrujilloSonam Dodhia*Address correspondence to: Sonam Dodhia, MD, Department of Otolaryngology/Head and Neck Surgery, New York Presbyterian Hospital, Columbia University Medical Center, 180 Fort Washington Avenue 8th Floor, New York, NY 10032, USA. E-mail Address: snd7005@nyp.orghttps://orcid.org/0000-0002-8195-0475Department of Otolaryngology/Head and Neck Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.Search for more papers by this author, Ade ObayemiDepartment of Otolaryngology/Head and Neck Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.Search for more papers by this author, Kevin KuonquiDepartment of Otolaryngology/Head and Neck Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.Search for more papers by this author, and Oscar TrujilloDepartment of Otolaryngology/Head and Neck Surgery, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.Search for more papers by this authorPublished Online:5 May 2023https://doi.org/10.1089/fpsam.2022.0396AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"L-Strut Division Technique for Correction of Anterocaudal Septal Deviation: Functional and Cosmetic Outcomes." Facial Plastic Surgery & Aesthetic Medicine, , pp. FiguresReferencesRelatedDetails Volume 0Issue 0 InformationCopyright 2023, American Academy of Facial Plastic and Reconstructive Surgery, Inc.To cite this article:Sonam Dodhia, Ade Obayemi, Kevin Kuonqui, and Oscar Trujillo.L-Strut Division Technique for Correction of Anterocaudal Septal Deviation: Functional and Cosmetic Outcomes.Facial Plastic Surgery & Aesthetic Medicine.ahead of printhttp://doi.org/10.1089/fpsam.2022.0396Online Ahead of Print:May 5, 2023PDF download

Is Computed Tomography Necessary Before Septoplasty? Correlation With Physical Examination and Patient Complaints.

Septoplasty is one of the most common surgeries performed by otorhinolaryngologists. The gold standard for the evaluation of septal deviation is anterior rhinoscopy and nasal endoscopy. Frequently, computed tomography (CT) is also performed, although the correlation between septal deviation on CT and physical examination is unclear. To study the relationship between symptoms and physical and radiological evaluation in patients who underwent septoplasty. A prospective study of patients with nasal obstruction and septal deviation who underwent septoplasty. Anterior rhinoscopy and nasal endoscopy were performed by the surgeon, and the CT was evaluated by a radiologist. The degree of obstruction was evaluated in three distinct septal locations. The Nasal Obstruction Symptom Evaluation (NOSE) score was used before the surgery and two months after the surgery. The study included 43 patients, of whom 60.5% were male, with an average age of 37.09 years (±12.56). The degree of septal deviation in the physical examination was significantly different from that observed in CT (p˂0.05).Cartilaginous or maxillary crest septal deviations >75% were more commonly recognized by physical examination, while osseous septum deviations of 25%-50% were more easily detected by CT.There was no difference between the degree of septal deviation and the preoperative NOSE. The median preoperative NOSE was 60, and the postoperative was 5, with significant improvement (p<0.05). CT doesn't appear to be useful in the evaluation of septal deviation since it is different from the findings of a physical examination and isn't associated with the NOSE score. Clinical decisions should be based on a physical examination and patient complaints.

Comparison of Nasal Functional Outcomes, Sleep Quality, and Anxiety Parameters Following Septoplasty in Patients with Different Septum Deviation Types

Comparison of Nasal Functional Outcomes, Sleep Quality, and Anxiety Parameters Following Septoplasty in Patients with Different Septum Deviation Types

Do Nasal Anatomical Variations Affect the Maxillary Sinus? A CBCT Volumetric Analysis

Objective: This study aimed to determine the effect of the concha bullosa (CB) and the nasal septum deviation (NSD) on the volume of the maxillary sinuses using ITK-SNAP (http://www.itksnap.org/ download/snap/). Methods: A total of 70 CBCT scans were analyzed. Three groups were evaluated; control (absence of CB), unilateral CB, and bilateral CB. Moreover, scans were classified according to the NSD into control (no deviation), mild, moderate, and severe NSD deviation. The volume of each maxillary sinus was calculated using the ITKSNAP. Intra-observer reliability analysis was performed by paired-sample t-test. Analysis of variance ANOVA and t-test were used to compare the mean bilateral maxillary sinus volumes. Results: Intra-observer reliability for the maxillary sinus volume exhibited no significant difference for both sides (p &gt; 0.05). The mean volume of the right and left maxillary sinuses were 12.98±4.90 cm3 and 13.18±4.99 cm3 , respectively. No significant difference between the volumes of both sides (p &gt; 0.05) was found. The results showed no significant differences between the CB or NSD groups on both sides (p &gt; 0.05). Conclusion: The two anatomical variations have no effect on the maxillary sinus volume. The open-source software ITK-SNAP is a valuable tool for volumetric analysis.

CT of Anatomic Variants of Sinonasal region and its correlation with symptoms of Rhinosinusitis

Background: Sinonasal region is subjected to wide anatomical variation. The paranasal sinuses (PNS) create a connection with nasal cavity. They are placed in close proximity to nose. The four paranasalsinuses ;maxillary, ethmoid, sphenoid, and frontal, are named after their coinciding bone. Computed Tomography (CT Scan )is important modality to describe the location of these paranasal sinuses. Aim: To ascertain the frequency of various anatomic variants of sinonasal region in population of Sahiwaland itsassociation with symptoms of rhinosinusitis. Methods: This descriptive cross sectional study was conducted in Sahiwal Teaching Hospital from 10th June 2022 – 10th December 2022, with collaboration of Radiology and otorhinolaryngeology Departments. 60 symptomatic subjects between 18-60 years of age, irrespective of gender with rhinosinusitiswere taken.They underwent CT Scan of paranasal sinuses. The findings of CT Scan related to nasal-septum, turbinates, uncinate process, ethmoid air-cells and other anatomical variants corresponded with symptoms of rhinosinusitis. The data was analyzed using SPSS version 23.0. Frequency, percentages and p-value of different variants were calculated. The p-value of ≤ 0.05 was considered as significant. Results: Our study showed 63.3% males and 36.7% females. The mean age of our subjects was 30.65 + 12.7 years. The most frequently seen anatomical variants in our population were nasal septum deviation (86.7%) followed by aggernasi cells (68.3%) and asymmetry of both sides of sphenoid sinuses (68.3%). The statically significant association was noted between concha bullosa of middle turbinate and nasal obstruction ( p-value 0.001) and between rhinorrhea and asymmetry of both sides of sphenoid sinus ( p-value 0.035) Practical Implications &amp; Conclusion: We concluded from our study that that however there is no significant association between rhinosinusitis and most of the anatomic variants of sinonasal region except concha bullosa of middle turbinate and asymmetry of both sides of sphenoid sinus. But to avoid operative complexities, a surgeon must be well aware of these diverse variants. Keywords: Anatomical variations, CT-scan, Rhinosinusitis

Correlation between chronic suppurative otitis media and deviated nasal septum of the ipsilateral side

Background: Chronic suppurative otitis media (CSOM) is a long standing infection of middle ear with permanent defect in tympanic membrane with or without ear discharge, frequently have an underlying nasal pathology, which can worsen the middle ear disease secondary to Eustachian tube dysfunction, leading to negative middle ear pressure, tympanic membrane retraction, chronic otitis media with effusion and/or cholesteatoma. Present study was conducted to study the correlation of a etiopathogenesis, bacteriology of CSOM with the deviation of the nasal septum (DNS) of the ipsilateral side. Methods: Study was conducted in ENT department, AJ institute of medical science, Mangalore, Karnataka. Study group included 120 patients having CSOM, selected randomly from outpatient department (Time bound cross-sectional study). Predesigned proforma was used. Detailed history taken, followed by a thorough ENT examination. Relevant investigations were performed. Results: In this study, the prevalence of nasal disease (DNS) in patients with CSOM was 73.33%. Out of 120 CSOM patients, 88 patients had co-existent nasal disease (DNS). Among the 88 cases; 71 (59.2%) patients showed direct correlation with CSOM. Culture swabs showed similar bacterial isolates in aural and nasal swabs indicating, there may be retrograde spread of pathogens from nasopharynx to middle ear via Eustachian tube. Conclusions: A significant correlation was established between CSOM and DNS of the ipsilateral side. DNS played a key role in persistence of CSOM. A conscientious evaluation of nose and paranasal sinuses diseases is essential and we thus endorse management of nasal disease prior to the surgical treatment of ear disease, for meritful postoperative results.

Safety and Feasibility of Hypnosis-Induced Sleep Endoscopy in Obstructive Sleep Apnea Patients.

Hypnosis was never used in sleep endoscopy assessment of obstructive sleep apnea syndrome (OSAS). The aim of the study was to assess the feasibility, safety, and patient satisfaction of hypnosis-induced sleep endoscopy (HISE). From January to July 2021, 24 adults with moderate-to-severe OSAS at the polysomnography were included in the HISE protocol. The following outcomes were evaluated by the otolaryngologist and the hypnotherapist: safety, feasibility, and performance. The patient outcomes were assessed through a patient-reported outcome questionnaire assessing hypnosis acceptance, stress, anxiety, nasofibroscopy examination pain, and discomfort. Twenty-three patients completed the evaluations (16 males). The mean age of patients was 50.8years. The nasofibroscopy was well-tolerated with low levels of stress during the HISE. Otolaryngologist adequately completed the VOTE scoring in 22 patients (95.7%). Hypnosis was ineffective in one patient because he felt pain during the nasofibroscopy procedure due to an important septal deviation. The hypnotherapist reported adequate satisfaction outcomes, with better results for trance compliance compared to other steps. There were no adverse effects or complications. The percentage of snoring was negatively associated with the level of consciousness during hypnosis (p = 0.012). The easiness of nasofibroscopy was positively associated with the levels of muscle relaxation (p = 0.036) and consciousness (P = 0.002). HISE is an effective alternative approach for the work-up of OSAS. Future controlled studies are needed to compare HISE with drug-induced sleep endoscopy and assess the cost-effective outcomes of both approaches.

Feminizing Rhinoplasty: A Systematic and Institutional Review of Operative Techniques and Clinical Outcomes

Background: Facial gender-affirming surgery encompasses a myriad of procedures ranging from skeletal to soft tissue maneuvers depending on the manifestation of dysphoria in individual patients. In this work, we reviewed techniques for feminizing rhinoplasty in a single center and performed a systematic review of the literature. Methods: A systematic literature review was performed in order to survey articles that discussed techniques and clinical considerations when performing rhinoplasty among transgender females and non-binary patients. In addition, a retrospective review of such patients undergoing rhinoplasty by the senior author. Variables collected included demographic factors, operative details, and post-operative events. Results: Initial review yielded 56 articles. Standardized application of inclusion and exclusion criteria resulted in a total of 12 studies. Priorities of feminizing rhinoplasty entail reduction of dorsal hump, as well as tip refinement and deprojection. Sixty-five patients were included for analysis. The majority of patients underwent rhinoplasty through an open approach (83%). For the dorsum, 89% received dorsal reduction and 80% underwent percutaneous osteotomies. For tip work, 37 (56.9%) received a septal caudal extension graft, while a minority of patients required columellar strut (25%) or tip graft (8%). For functional restoration, septoplasty (71%) and spreader flaps/grafts (58%) were utilized to correct internal valve collapse, while alar rim (8%) and alar crural strut (3%) grafts were performed to address external valve collapse. Complications included septal deviation, hypertrophic scar, and contour irregularity. Two patients required revision (3%). Conclusion: The core tenets of the operation lie in the reduction of the nose, tip deprojection and rotation, as well as the creation of harmony with other facial structures. Our multi-pronged analysis presents an updated review of these principles, as well as a longitudinal outlook on outcomes associated with feminizing rhinoplasty.

Effect of Nasal Septum Deviation on the Choroidal Thickness.

Nasal cavity blood circulation and ocular blood circulation have common pathways for both arterial blood supply and venous drainage. Therefore, nasal pathologies can affect ocular blood circulation. This study aimed to evaluate the relationship between nasal obstruction and choroidal thickness. A prospective study was planned by forming a group of 144 patients diagnosed with nasal septum deviation at the otorhinolaryngology clinic and 100 healthy voluntary individuals. Of the total, 69 patients with nasal right septum deviation were evaluated as Group 1, 75 patients with nasal left septum deviation as Group 2, and 100 healthy volunteers as the control group. Detailed ophthalmological examinations of all the participants were performed, and choroidal thickness was measured using spectral domain optical coherence tomography. The relationship between choroidal thickness and ocular parameters was evaluated and compared between the patient groups with nasal septum deviation and the control group. When the choroidal thickness measurements of the patients in Group 1 were examined, the choroidal thickness increased in all the regions in the eye contralateral to the deviation side (left), and intraocular pressure (IOP) was higher compared to the eye on the deviation side (right) and the control group at a statistically significant level. In Group 2, the choroidal thickness measurements increased in all the regions in the eye contralateral to the deviation side (right), and IOP was higher compared to the deviation side (left) and the control group. We found that the patients with nasal septum deviation hadhigher choroidal thickness and IOP values in the eye contralateral to deviation.

Correlation between Pneumatization Variants of Paranasal Sinuses and Skull Base and Spontaneous Cerebrospinal Fluid Rhinorrhea: A Case-Control Study

Introduction: Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) is the most common type of cerebrospinal fluid leakage and may cause serious cerebral complications. The aim of this research was to investigate the relationship between the degree of pneumatization variants of the paranasal sinus and skull base and the incidence of SCSFR. Methods: In total, 131 patients with SCSFR were analyzed, and 50 patients suffering from the nasal septal deviation were selected as controls. The pneumatization of the paranasal sinus and skull base was observed by CT scan. Results: Among the 137 fistulas, 55 (40.15%) were found in the ethmoid sinus. The incidences of Onodi cells (27.27 vs. 8%) and type 3 lateral recess of the sphenoid sinus (LRSS, 70.37 vs. 22%) in the SCSFR subgroups were significantly higher than those in the control group (p < 0.05). Moreover, the occurrence of SCSFR was linearly correlated with the classification of Onodi cells and LRSS (p < 0.05). There was no significant difference in the incidence of frontal cells, anterior clinoid process pneumatization, and posterior clinoid process pneumatization between the SCSFR patients and the controls. Conclusion: The most common site of SCSFR is the ethmoid sinus. The excessive pneumatization of the Onodi cell and LRSS increases the risk for the occurrence of SCSFR in the ethmoid sinus and sphenoid sinus, respectively. The possible association between the paranasal sinus ontogeny and SCSFR pathophysiology needs further studies.

The Variations in Deviation of Nasal Septum and their Impact on Maxillary Sinus Volume and Occurrence of Sinusitis.

To study the effect of variations in deviation of the nasal septum and their impact on maxillary sinus volume and occurrence of sinusitis. This prospective observational study was conducted in the department of ENT, Head &Neck surgery GMC Jammu from August 2021 to November 2022. 130 patients (90 males, 40 females), with age range of 18-47years with DNS were included in the study. Grade of DNS was classified according to Mladina's classification and volume of maxillary sinus was calculated using geometric formula by performing 256 slice CT Scan. In our study mean age of the males was 32.8 ± 6.99years and females was 33.7 ± 7.26years with Male: Female ratio of 9:4.Patients with grade 1 DNS had mean maxillary sinus volume of 9.9 ± 1.97cumm while patients with grade 7 DNS had mean maxillary sinus volume of 3.8 ± 1.47cumm. Thus, with the increasing grade of DNS, the OMC blockage increased towards the side of DNS and so the occurrence of maxillary sinusitis. The study showed that with high grade DNS, the maxillary sinus volume decreases on the side of septum deviation and there is association of blocked OMC with increasing grade of DNS. The incidence of maxillary sinusitis findings on the side of septum deviation was significantly increased.

Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta-analysis.

Septoplasty is the most frequently performed ENT surgery to correct nasal septal deviation (NSD). The present study aimed to quantify the effectiveness of septoplasty with or without turbinate surgery according to NOSE questionnaire scores, with the hypothesis that it is able to clinically improve patient-reported nasal obstructive symptoms in the post-operative follow-up. An electronic search was performed on PubMed/MEDLINE, Embase, and Cochrane Library. The primary outcome was the change in NOSE score at 6 months after surgery. It was assessed with the mean difference (MD) between baseline and postoperative results. A total of 2577 patients (males: 65.1%, 95% CI: 59.9-70.2) with a mean age of 33.3 years (n = 1456, 95% CI: 30.4-36.2) were included in this meta-analysis. The pooled baseline NOSE mean score was 68.1 (n = 2577, 95% CI: 64.3-71.9). The pooled MD in NOSE score at 6-months follow-up compared to baseline was -48.8 (n = 1730, 95% CI: -54.6 to -42.9). Functional septoplasty with or without turbinate surgery shows a critical improvement of obstructive symptoms and quality of life according to the validated NOSE score. NA Laryngoscope, 133:3237-3246, 2023.

Endoscopic Septoplasty: A Retrospective Analysis of Indications and Outcome.

Endoscopic septoplasty is a minimally invasive surgical procedure for the correction of nasal septal deformity. Globally, nasal septal surgeries are rarely performed, and in our country these procedures are even more scarcely undertaken, partly due to dearth of facilities and to some extent, the expertise of embarking on this specialised surgical procedure. Therefore, we aimed to document the indications and the outcome of endoscopic septoplasty in our environment. This was a retrospective study of all consecutive patients that had endoscopic septoplasty at a state tertiary hospital over three years period. Ethical approval was obtained before commencement of the study. Patients' medical records were retrieved. Biodata, clinical presentation, operative procedure and outcome were extracted and analyzed descriptively. Fourteen patients had endoscopic septoplasty over the period under review, constituting 11 (78.6%) males and 3 (21.4%) females. Predominant clinical features were nasal obstruction (100%) and nasal septal deviation (100%). The main indication for procedure was deviated nasal septum. The outcome of the surgery was good, 2(14.3%) of the patients had nasal adhesions but no major complication was recorded. The length of hospital stay ranged between 3 and 5 days with a mean of 3.7 ± 0.9 days, and all the patients were discharged successfully. Endoscopic septoplasty is a safe surgery. The main indication for the procedure was deviated nasal septum, and the procedure has a favourable outcome among the operated patients.

Variations of the Nasal Septum in Adult Nigerians: Computed Tomography Study

Introduction The morphological variants of the nasal septum have been implicated in sinus pathology and pose a challenge during endoscopic surgeries. Objective The present study aimed at evaluating the prevalence of nasal septum variants in adult Nigerians. Methods The present study was performed at the Radiology Department of Delta State University Teaching Hospital, Nigeria, following ethical approval. Brain computed tomography (CT) scan images of 336 adults were evaluated for nasal septum variants. The angle of the deviated nasal septum was measured, and the severity was classified. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY, USA). The angle of deviation was presented in means and standard deviation. Frequencies of the variants were presented in percentages. The Student t -test was used to compare the angle of deviation, while the chi-squared test was used to compare the frequencies in the different groups. A p-value < 0.05 was considered statistically significant. Results The prevalence of straight and deviated nasal septum was 59.5% and 40.5%, respectively. Deviation was predominant in females (46%) and, more frequently, of moderate severity (75%). The angle of deviation was significantly larger in males (12.55 ± 2.99°) than in females (11.13 ± 2.41°; p = 0.003). Nasal spur had a prevalence of 11.9%, and its coexistence with deviated nasal septum was observed in 5.06%. Septal pneumatization was seen in 10 patients (3%). Conclusion Deviation of the nasal septum occurred more in females and toward the left; however, the angle of deviation was significantly higher in males. Nasal septal spur and pneumatization were the least prevalent variants.

Postseptoplasty Quality of Life among Patients in Aseer Region, Saudi Arabia

Background: Deviated nasal septum is among the most common causes of nasal obstruction (NO) in adults. The efficacy of septoplasty for the treatment of septal deviation and the predictors of satisfactory surgical outcomes remains controversial. A significant improvement in the preoperative NO symptom evaluation score was noted after 3 months. Septoplasty resulted in a significant improvement in the disease-specific quality of life (QOL). Aim: The aim was to examine the postseptoplasty QoL and symptoms in patients in Aseer region, Saudi Arabia. Methodology: A descriptive follow-up study was conducted to assess postseptoplasty QoL in patients who underwent surgery from 2020 to 2022. Patients with psychological, behavioral, and severe chronic health problems were excluded. Information on demographic data and postsurgical symptoms was collected. QoL was assessed using the Sino-Nasal Outcome Test 20 questionnaire. Results: A total of 246 patients who underwent septoplasty were included. Patients' age ranged from 19 to 55 years, with a mean age of 33.6 years. Furthermore, 148 (60.2%) patients were men and 104 (42.3%) were aged &gt; 40 years. In terms of rhinological symptoms, 87.8% of the patients reported their need to blow nose, 82.9% had sneezing, 72.8% had a runny nose, 69.6% complained of thick nasal discharge, and 69.1% had postsurgical discharge. Furthermore, 43.5%, 43.9%, 41.1%, 40.7%, 32.9%, and 30.9% of the patients experienced NO, headache, oral breathing, sinusitis, smell disturbance, and snoring, respectively. Conclusions and Recommendations: A clinically significant improvement was noted in olfactory and rhinological symptoms after septoplasty and thus QoL. Psychological and otorhinological functions showed more improvement than rhinological functions.