Endoscopic Aided Septoplasty Versus Conventional Septoplasty

Septoplasty is a commonly performed surgical procedure aimed at relieving nasal airway obstruction. The advent of the nasal endoscopes facilitates accurate identification of the pathology. Further limited elevation of the flap, minimal resection and realignment are possible. The present study was conducted for comparison between septoplasty done by the conventional technique and the endoscopic septoplasty in terms of relief of the symptoms of patients including nasal obstruction, efficacy in the relief of headache, hyposmia and post-nasal drip and synchiae formation following either surgery. This study was conducted at the department of ENT, Riyadh National Hospital, Saudi Arabia from January 2011 to March 2013. Eighty patients with deviated nasal septum were recruited into study where the patients were divided into two groups, 40 cases in each group. Group I underwent conventional septoplasty while group II underwent endoscopic seoptoplasty. All of the patients had nasal septal deformities associated with other sinus or nasal pathology. Most prevalent complaint in the patients was nasal obstruction (90%), headache (40%), nasal discharge (20%) and sneezing (18%). The most prevalent pathology is hypertrophy of inferior turbinate (81%) followed by cocha-bullosa and mucosal disease (20% for each), polypoid middle turbinate (18%), paradoxical middle turbinate (17%) and uncinate process abnormality (15%). They were 70% males and 30% females. The median of age was 32.3 years. The post-operative follow-up of frequency of symptoms after surgery showed relive of nasal obstruction in 30% of cases of group I and in 90% of group II. However, headache was relieved in 40% of cases of conventional septoplasty and 60% of cases of endoscopic septoplasty. Post-nasal drip was relieved among 50% of patients underwent endoscopic septoplasty while it was relieved in 10% only in who had conventional septoplasty. Objective assessment at last follow-up visit among study subjects revealed that 5 cases of conventional septoplasty group and 3 of endoscopic septoplasty cases had persistent anterior deviation. While, 14 cases of group I and 3 cases of group II had persistent posterior deviation. Spur and synechia were persisting in 8 and 6 cases that underwent conventional septoplasty, respectively. One case from each group still had Spur and synechia after endoscopic septoplasty. There was significantly less persistence of posterior deviation, spur and synchia in group II patients than group I. No major complications in the immediate post-operative period were observed. Minor complications such as haemorrhage occurred in one patient and septal haematoma in one patient. Endoscopic septoplasty was found effective in relieving almost all symptoms, especially headache, nasal obstruction and post-nasal drip. Endoscopic septoplasty is associated with significant reduction in patient's morbidity.