Endoscopic Septoplasty: A Prospective Analysis
Background: The advent of endoscopes has revolutionized rhinology. Endoscopic Septoplasty is a fast developing concept and gaining popularity because of its potentially insignificant subjective and objective morbidity. Objectives: This study was aimed to analyze patients undergoing Septoplasty defining its indication, procedure, benefits and follows up. Methods: From March 2011 to May 2012, 40 patients underwent Endoscopic Septoplasty at the postgraduate Deptt. of ENT, S.M.H.S hospital, Srinagar Kashmir. Patients who presented with signs and symptoms attributed to posterior septal deviation, septal spurs and limited septal deviation directly opposite the surgical area for endoscopic sinus surgery and endoscopic Dacrocystorhinostomy were selected. Results: Nasal obstruction was the most common presenting symptom recorded in 39 (97.2%) patients. Endoscopic Septoplasty alone or with Turbinoplasty was done in 22 (55%) patients. In rest 18 patients, endoscopic Septoplasty was done with FESS in 9 (22.50%), with DCR in 5 (12.50%), with decompression/marsupialization of Sinonasal Mucocele in 3 (7.50%) and with CSF leak repair in 1 (2.50%) patients. Preoperative nasal endoscopy revealed broad based septal deformity in 12 (45%) patients, isolated spur in 10 (35%) patients and combined septal deformity in 18 (20%) patients. Majority of patients (n=38, 95%) were discharged within 48 hours. On analysis of septal deviation angles, on NCCT PNS, preoperative and postoperative mean ± S.D angle was 141 ± 11.89 and 167±7.36 with p value < 0.0001. On subjective analysis of nasal obstruction symptom evaluation (NOSE) score of patients at baseline, at postoperative 3 and 6 months follow up mean ± S.D was 61.88±11.53, 9.50±5.75 and 8.75±3.86.Conclusion: Endoscopic Septoplasty is an effective technique that can be performed safely alone or in combination with endoscopic sinus surgery with minimal additional morbidity. The endoscopic approach to Septoplasty facilitates accurate identification of pathology due to better illumination, improved accessibility to remote areas and magnification.
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