Clinical Consensus Statement

Abstract

This clinical consensus statement was developed by and for otolaryngologists and is intended to promote appropriate and, when possible, evidence-based care for patients undergoing septoplasty with or without inferior turbinate reduction. A complete definition of septoplasty with or without inferior turbinate reduction was first developed, and additional statements were subsequently produced and evaluated addressing diagnosis, medical management prior to septoplasty, and surgical considerations, as well as the appropriate role of perioperative, postoperative, and adjuvant procedures, in addition to outcomes. Additionally, a series of clinical statements were developed, such as "Computed tomography scan may not accurately demonstrate the degree of septal deviation," "Septoplasty can assist delivery of intranasal medications to the nasal cavity," "Endoscopy can be used to improve visualization of posterior-based septal deviation during septoplasty," and "Quilting sutures can obviate the need for nasal packing after septoplasty." It is anticipated that the application of these principles will result in decreased variations in the care of septoplasty patients and an increase in the quality of care.

A comparison of symptoms and quality of life before and after nasal septoplasty and radiofrequency therapy of the inferior turbinate

“…Patients with symptoms of nasal obstruction frequently consult an otorhinolaryngologist [ 1 ]. Nasal obstruction negatively affects patients’ quality of life (QOL) [ 1 – 3 ].…”

“…Patients with symptoms of nasal obstruction frequently consult an otorhinolaryngologist [ 1 ]. Nasal obstruction negatively affects patients’ quality of life (QOL) [ 1 – 3 ]. Sustained nasal obstruction may have anatomical or structural causes such as deviation of the nasal septum or inferior turbinate hypertrophy (ITH) [ 4 ], but chronic diseases such as chronic rhinosinusitis (CRS) and allergic rhinitis (AR) [ 5 , 6 ] also cause nasal congestion and reduced nasal airflow.…”

“…Normally, patients are treated medically with anti-histamines, topical decongestants and corticosteroids; surgery is reserved for refractory cases [ 11 , 12 ]. During the last decade, radiofrequency therapy of the ITH (RFIT) has been performed more frequently in combination with septoplasty [ 1 ] or as a single approach to reduce nasal obstruction in patients with ITH [ 13 – 15 ]. Various surgery techniques have been used to reduce ITH, but radiofrequency coblation and microdebrider-assisted turbinoplasty are common methods because they are easy to perform [ 12 , 16 ].…”

Acute pain intensity in men and women after septoplasty

“…Furthermore, systematic review of 7 randomised controlled trials with the participation of 869 patients where transseptal suturing was compared to nasal packing showed nasal ache and headache were significantly less in trans-septal suturing case while postoperative complications including bleeding, haematoma, nasal adhesion, septal perforation and local infectious complications had no intergroup differences [22]. Having regard to these data it might be concluded that trans-septal suturing allowed to avoid the need for nasal packing after septoplasty and hence to avoid nasal pain, discomfort and other risks of nasal packing [30]. We didn't observe any complications during 3 days nasal packing.…”

Nasal septum suture combined with inferior turbinate coblation after septoplasty: Does it improve quality of life and reduce complications?

“…As a result, some surgeons suggest that inferior turbinate reduction should be performed simultaneously during septoplasty. 17 , 18 …”