Saxena Arpit, Khan Danish Ahmad, Anas Md
Department of ENT, Dr. B.S. Kushwah Institute of Medical Sciences, Kanpur, Uttar Pradesh India.
Senior ENT surgeon, Regional Hospital Baghmara, Bharat Coking Coal Limited (BCCL), Baghmara, Dhanbad, Jharkhand India.
Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2301-2308. doi: 10.1007/s12070-025-05492-7. Epub 2025 Apr 28.
Nasal septal deviation (NSD) is one of the most common structural abnormalities contributing to nasal obstruction, which significantly affects patients' quality of life. Septoplasty is the surgical procedure of choice to correct NSD. Traditionally performed via an open approach, endoscopic septoplasty has emerged as a minimally invasive alternative. However, there remains ongoing debate regarding the comparative effectiveness, patient satisfaction, and postoperative outcomes of these two techniques. This study aimed to compare the clinical and patient-reported outcomes of conventional versus endoscopic septoplasty using the Nasal Obstruction Symptom Evaluation (NOSE) and the 22-item Sino-Nasal Outcome Test (SNOT-22)questionnaires.
A prospective, comparative study was conducted on 120 adult patients (60 undergoing conventional septoplasty and 60 undergoing endoscopic septoplasty) with symptomatic NSD. The NOSE and SNOT-22 questionnaires were administered preoperatively and at 1, 3, and 6 months postoperatively. Data analysis included comparisons of symptom scores, complication rates, and correlation with demographic factors.
Both groups demonstrated significant improvement in NOSE and SNOT-22 scores at all postoperative follow-up points compared to baseline ( < 0.001). However, patients undergoing endoscopic septoplasty had marginally better symptom relief (lower mean postoperative NOSE and SNOT-22 scores) and fewer postoperative complications compared to those undergoing conventional septoplasty. Operative time was shorter in the conventional group, but overall patient satisfaction at 6 months was higher in the endoscopic group.
Both conventional and endoscopic septoplasty lead to significant improvements in nasal obstruction and related sinonasal symptoms as measured by NOSE and SNOT-22. Endoscopic septoplasty may offer additional benefits in terms of reduced complication rates and improved patient satisfaction, although conventional septoplasty remains a viable and effective option for correcting NSD. Further larger-scale, long-term studies are suggested to confirm these findings and optimize surgical decision-making.
鼻中隔偏曲(NSD)是导致鼻塞的最常见结构异常之一,严重影响患者的生活质量。鼻中隔成形术是矫正NSD的首选外科手术。传统上通过开放式手术进行,内镜鼻中隔成形术已成为一种微创替代方法。然而,关于这两种技术的相对有效性、患者满意度和术后结果仍存在争议。本研究旨在使用鼻阻塞症状评估(NOSE)和22项鼻-鼻窦结局测试(SNOT-22)问卷比较传统鼻中隔成形术与内镜鼻中隔成形术的临床和患者报告结局。
对120例有症状的NSD成年患者进行了一项前瞻性比较研究(60例行传统鼻中隔成形术,60例行内镜鼻中隔成形术)。术前以及术后1、3和6个月进行NOSE和SNOT-22问卷调查。数据分析包括症状评分比较、并发症发生率以及与人口统计学因素的相关性。
与基线相比,两组在所有术后随访点的NOSE和SNOT-22评分均有显著改善(<0.001)。然而,与接受传统鼻中隔成形术的患者相比,接受内镜鼻中隔成形术的患者症状缓解略好(术后平均NOSE和SNOT-22评分较低),术后并发症较少。传统组的手术时间较短,但内镜组6个月时的总体患者满意度较高。
根据NOSE和SNOT-22测量,传统和内镜鼻中隔成形术均能显著改善鼻塞及相关鼻-鼻窦症状。内镜鼻中隔成形术在降低并发症发生率和提高患者满意度方面可能具有额外益处,尽管传统鼻中隔成形术仍是矫正NSD的可行且有效选择。建议进一步开展更大规模的长期研究以证实这些发现并优化手术决策。