Endoscopic septoplasty verses conventional septoplasty in management of deviated nasal septum: a comparative evaluation

Abstract

Background: Deviated nasal septum is one of the common causes of nasal obstruction. Correction of deviated nasal septum has been performed by a variety of techniques of which Septoplasty is the most popular one. With the advent of endoscopes and their successful use in endoscopic sinus surgery, endoscopes have been tried in septoplasty for better visualization of posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. Aim: The aim of the study was to study the advantages and disadvantages of endoscopic septoplasty and conventional septoplasty and to co-relate the two procedures in terms of intra-operative visualization, duration of surgery, procedural difficulties, hospital stay and complications. Material and methods: The present study  done to compare the conventional and endoscopic septoplasty was carried out in the Department of ENT, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India, for 1 year. Total 100 Patients with symptomatic DNS with no other comorbidities and willing for surgical treatment were included. Data was collected by selecting the patients with DNS willing for surgery. They were divided into two groups; one group undergoing conventional septoplasty and the other endoscopic septoplasty by random selection and following up the patients preoperatively and postoperatively.  Results:  Out of 100 patients, 40 were females (40%) and 60 were males (60%). Among 40 females, 20 patients underwent endoscopic and 20 patients underwent conventional septoplasty. Out of 60 males 30 patients underwent endoscopic and 30 patients underwent conventional septoplasty. Mean age was 40.13±11.67. In the present study, major pre-operative symptom was found to be nasal obstruction 88%, followed by headache 54%, postnasal drip 49%, hyposmia 48% and epistaxis 33%. It was observed that the mean time taken for conventional septoplasty was 33.11 minutes standard deviation 6.12 On the other hand endoscopic septoplasty required 25.41 minutes standard deviation 5.62. There was significant subjective improvement among patients of both groups. Conclusion: For minimal and posterior deviations of the septum, endoscopic septoplasty is better, whereas for anterior deviations, conventional septoplasty could be better choice.

Keywords: Deviated nasal septum, Conventional septoplasty, Endoscopic septoplasty.