A comparative study of endoscopic versus conventional septoplasty

Abstract

<p class="abstract"><strong>Background:</strong> 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. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplasty.</p><p class="abstract"><strong>Methods:</strong> It was a prospective observational study conducted on 50 patients with deviated nasal septum, who presented to ENT department of SPMC, Bikaner, patients were randomly divided equally in two groups for conventional and endoscopic septoplasty respectively. Data collected on a prestructured proforma and results analysed. </p><p class="abstract"><strong>Results:</strong> The study included 50 cases. Postoperatively significant relief from the symptoms of nasal obstruction (82%) in group A and (96%) group B, was seen. In objective assessment at the end of 3 months of surgery, patient had persistent posterior deviation 24% in group A and 3% in group B, spur 12% in group A and 0% in group B.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.</p>

Endoscopic septoplasty versus conventional septoplasty for nasal septum deviation: a systematic review and meta-analysis of randomized clinical trials

“…Our results are consistent with those of numerous other studies that have found synechiae formation to be more likely in patients who received conventional septoplasty as opposed to endoscopic septoplasty 23 , 30 , 31 . In one study by Talluri et al , synechiae development was observed in 18.6% of the traditional septoplasty group and 4% of the endoscopic septoplasty group 29 .…”

“…Chandra et al and Sherief et al found that 4% of patients in the endoscopic group and 16% of patients in the conventional group had a persistently deviated nasal septum, which is similar to our findings 23 , 24 . Talluri et al also revealed that 13.3% of conventional septoplasties and 6.6% of endoscopic septoplasties were found to involve partial repair 29 .…”

“…Relief of nasal obstruction was reported in nine studies with 499 patients 8 , 14 – 16 , 18 – 20 , 22 , 23 . The pooled RR of studies with short-term follow-up [RR=1.20, 95% CI=(1.09,1.32), P =0.0003] and long-term follow-up [RR=1.17, 95% CI=(1.02,1.35), P =0.03] significantly favored endoscopic septoplasty.…”

“…to 24 months in Bothra Mathur 25 . Eight studies were conducted in India 8 , 14 – 16 , 18 , 22 , 23 , 25 , three in Egypt 20 , 21 , 24 , one in Israel 19 , and one in Canada 17 . Thirty-two patients suffered from C type septal deviation, 18 patients suffered from S type septal deviation, seven patients suffered from both types, 23 suffered from a right septal deviation, and 27 patients suffered from a left septal deviation; the remaining patients’ septal deviation types were not reported.…”

“…Intraoperative and postoperative hemorrhage was reported in nine studies with 499 patients 8 , 14 , 16 – 19 , 22 , 23 , 25 . Endoscopic septoplasty was significantly associated with a lower incidence of intraoperative and postoperative hemorrhage than conventional septoplasty in the short-term [RR=0.27, 95% CI=(0.14,0.54), P =0.0002], as well as in the long-term [RR=0.13, 95% CI=(0.02,0.69), P =0.02].…”