Comparative Study of Septoplasty Alone and with FESS in Maxillary Sinusitis with Septal Deviation

Abstract

Introduction:The study was conducted to asses if septoplasty is adequate for the management of chronic maxillary sinusitis. Chronic maxillary sinusitis is not uncommonly associated with deviated nasal septum (DNS). The randomized study was conducted on 40 cases of medically unmanageable and HRCT proven chronic maxillary sinusitis with DNS. Materials and methods:The study was conducted in 40 cases of HRCT (PNS) proven chronic maxillary sinusitis which were not cured with medical treatment. The patients were divided randomly in two groups. Group A underwent septoplasty and group B septoplasty along with FESS in the form of uncinectomy and middle meatus antrostomy. Patients having other anatomical factors for example concha were excluded. Results:Both procedures produced significant improvement in symptomatology and on HRCT (PNS) findings as compared to preoperative status (p-value less than 0.001). Septoplasty was found to be effective in chronic maxillary sinusitis, however, when polyps were present in maxillary sinus, then septoplasty with FESS was found to be better. Discussion:In cases of chronic maxillary sinusitis with DNS, septoplasty is adequate, however if the maxillary sinus shows polyps on HRCT (PNS) scan then septoplasty should be combined with FESS.

Comparative evaluation of FESS and septoplasty with FESS in cases of DNS with chronic maxillary sinusitis

“…The success rate was higher in patients with septoplasty alone as compared to those in FESS with septoplasty suggesting adequacy of septoplasty alone in management of DNS with chronic maxillary sinusitis. 12,13 However, the adequacy of FESS alone in management of DNS with chronic maxillary sinusitis is not well documented.…”

“…Some studies have shown that septoplasty alone can be adequate for the treatment of DNS with CRS however, when polyps are present in maxillary sinus, then septoplasty with FESS was found to be better. 12,13 DNS causes different airflow dynamics in the nasal cavities which leads to development of compensatory hypertrophy of nasal mucosa of the opposite side of the deviated nasal septum. 18 DNS leads to increased chance of impaired mucocilliary clearance, OMC and development of sinusitis and sinusitis is more severe on opposite side of deviated nasal septum.…”