Bhardwaj Heemani, Kalsotra Gopika, Kalsotra Parmod, Singh Padam, Saraf Aditiya
Department of ENT and Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1724-1730. doi: 10.1007/s12070-023-03720-6. Epub 2023 Mar 29.
The most common cause of nasal obstruction is a deviated nasal septum. It causes breathing difficulties and may eventually also cause sinusitis, epistaxis, sleep disturbances and snoring. The traditional surgeries of the nasal septum improve the nasal airway but do not fulfil the essential criteria in most instances. Endoscopic septoplasty is a fast-developing concept and gaining popularity as it provides a direct targeted approach to the septal anatomic deformity allowing a minimally invasive procedure under excellent visualization. The aim of this study is to compare the post-operative morbidity among conventional and endoscopic septoplasty. The present prospective study was conducted on 50 patients having deviated nasal septum. Patients were randomly divided into two groups of 25 each. Out of 50 patients, in 25 patients (Group A) Conventional septoplasty was done, whereas in other 25 patients (Group B) endoscopic septoplasty was done. The patients were followed up post-operatively at 2 weeks, 4 weeks and 8 weeks. Study Design: comparative study. The mean of operating time (min) in Group A was 60.47 ± 8.16 which was significantly higher as compared to Group B (39.7 ± 6.73). ( value < .0001). The Mean of blood loss (mL) was significantly higher in Group A (88.67 ± 8.77) as compared to Group B. (54.6 ± 7.18). ( value < .0001). Post-operative NOSE score at one month was 7.33 ± 1.5 in group A which was significantly higher as compared to Group B (5 ± 1.41). ( value = 0.0007) whereas post-operative NOSE score at 3 months in Group A was 6.53 ± 1.25 which was significantly higher as compared to Group B (4.4 ± 1.78). Proportion of post-operative complications was comparable in Group A and Group B (No complication 80% vs. 92% respectively). According to the present study, both the conventional and endoscopic septoplasty procedures were effective in relieving nasal obstruction in the patients. Endoscopic septoplasty showed significantly better result than conventional septoplasty in terms of time taken for surgery, blood loss during the surgery, post-operative complications and in terms of quality of life as assessed by NOSE Score.
鼻中隔偏曲是鼻塞最常见的原因。它会导致呼吸困难，并最终可能引发鼻窦炎、鼻出血、睡眠障碍和打鼾。传统的鼻中隔手术虽能改善鼻腔气道，但在大多数情况下并不能满足基本标准。内镜鼻中隔成形术是一个快速发展的概念，且越来越受欢迎，因为它针对鼻中隔解剖畸形提供了一种直接的靶向方法，能在极佳的可视化条件下进行微创手术。本研究的目的是比较传统鼻中隔成形术和内镜鼻中隔成形术的术后发病率。本前瞻性研究针对50例鼻中隔偏曲患者开展。患者被随机分为两组，每组25例。在这50例患者中，25例患者（A组）接受了传统鼻中隔成形术，而另外25例患者（B组）接受了内镜鼻中隔成形术。术后对患者进行了2周、4周和8周的随访。研究设计：对比研究。A组的平均手术时间（分钟）为60.47±8.16，与B组（39.7±6.73）相比显著更长（P值<0.0001）。A组的平均失血量（毫升）（88.67±8.77）与B组（54.6±7.18）相比显著更高（P值<0.0001）。A组术后1个月的鼻功能评估量表（NOSE）评分为7.33±1.5，与B组（5±1.41）相比显著更高（P值=0.0007）；而A组术后3个月的NOSE评分为6.53±1.25，与B组（4.4±1.78）相比显著更高。A组和B组术后并发症的比例相当（无并发症分别为80%和92%）。根据本研究，传统鼻中隔成形术和内镜鼻中隔成形术在缓解患者鼻塞方面均有效。在内镜鼻中隔成形术在手术所需时间、术中失血量、术后并发症以及通过NOSE评分评估的生活质量方面，显示出比传统鼻中隔成形术明显更好的效果。
