Ahmed Ruman, Hiremath Chandrashekharayya S, Khavasi Prabhu, Malashetti Santosh P
Department of E.N.T and Head and Neck Surgery, S.Nijalingappa Medical College and H.S.K Hospital and Research Centre, Navanagar, Bagalkot, Karnataka 587103 India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3610-3620. doi: 10.1007/s12070-023-04029-0. Epub 2023 Jul 11.
Deviated nasal septum (DNS) causes nasal obstruction, secretions, decreased sense of smell, bleeding, headache and snoring. This study aims to compare endoscopic-assisted septoplasty versus conventional septoplasty in terms of surgical outcome and intra- and post-operative complications. A prospective study was done on 50 patients aged between 18 and 41 years of which, 41 (82%) cases were males and 9 (18%) were females who had DNS based on clinical examination and diagnostic nasal endoscopy. Patients were randomized by simple randomization into two groups. Functional outcome was assessed using nasal surgical questionnaire (NSQ) prior to and after surgery for 3 months post-operatively and complications associated with the surgery were compared between two groups. In this study, most of the patients had anterior dislocations, present in 37 cases (74%). Improvement in pre- to post-operative visual analogue scale (VAS) for nasal obstruction was significantly better in endoscopic-assisted than conventional septoplasty ( < 0.001*). Pre-and post-operative differences in 4-point likert scale for other nasal symptoms like decreased sense of smell, snoring, secretions, headache and crusting were better in endoscopic-assisted septoplasty ( < 0.001*). Complications in endoscopic-assisted septoplasty were less common compared to conventional septoplasty ( = 0.05). In endoscopic-assisted septoplasty patients, pre-to post-operative NSQ (Nasal Surgical Questionnaire) VAS improvement for nasal obstruction, likert scale change from pre-to post-op were better and complications were lesser compared to conventional septoplasty. This suggests endoscopic-assisted septoplasty has better surgical outcomes and fewer complications and posterior deviations, spurs and inferior deviations can be corrected with ease and fewer complications.
鼻中隔偏曲(DNS)会导致鼻塞、分泌物增多、嗅觉减退、出血、头痛和打鼾。本研究旨在比较内镜辅助鼻中隔成形术与传统鼻中隔成形术的手术效果以及术中和术后并发症。对50例年龄在18至41岁之间的患者进行了一项前瞻性研究,其中41例(82%)为男性,9例(18%)为女性,根据临床检查和诊断性鼻内镜检查确诊为DNS。患者通过简单随机化分为两组。在术前和术后3个月使用鼻外科问卷(NSQ)评估功能结果,并比较两组手术相关的并发症。在本研究中,大多数患者存在前脱位,共37例(74%)。内镜辅助鼻中隔成形术在术后鼻塞视觉模拟量表(VAS)的改善方面明显优于传统鼻中隔成形术(<0.001*)。在内镜辅助鼻中隔成形术中,嗅觉减退、打鼾、分泌物增多、头痛和结痂等其他鼻部症状在4分李克特量表上的术前和术后差异更好(<0.001*)。与传统鼻中隔成形术相比,内镜辅助鼻中隔成形术的并发症较少见(=0.05)。与传统鼻中隔成形术相比,内镜辅助鼻中隔成形术患者术后鼻塞的NSQ(鼻外科问卷)VAS改善、术前到术后李克特量表变化更好,并发症更少。这表明内镜辅助鼻中隔成形术具有更好的手术效果和更少的并发症,并且可以轻松纠正后脱位、骨刺和下偏曲,并发症更少。