EXTRACORPOREAL SEPTOPLA S TY USING POLYDIO XANONE PLATES v/s CONVENTIONAL SEPTOPLASTY IN MANAGEMENT OF DIFFICULT SEPTUM

Abstract

BACKGROUND:The technique and management of deviated nasal septum has evolved over the last few centuries. However, difficult and severely deviated septum still poses a surgical challenge. Difficult septum is characterized by severe malformations of cartilaginous, bony or both components, with significant airway block. Extracorporeal septoplasty with reconstruction with polydioxanone plates can be recommended as a viable alternative to conventional methods in management of such difficult septum. OBJECTIVE: To assess the clinical results and functional outcome of extracorporeal decortication septoplasty using polydioxanone (PDS) plate and compare the outcome with conventional septoplasty. METHODS: This is a prospective study of 60 patients who were managed by extracorporeal decortication septoplasty using PDS plates and conventional septoplasty. Preoperative and postoperative subjective assessment in the form of 'Nasal Outcome and Septoplasty Effectiveness scale' (NOSE score) and a modified 'Sinonasal Outcome Test' (SNOT score) was done. Patients were followed up using diagnostic nasal endoscopy. The functional outcome and complications were assessed. RESULTS: In our study we found a statistically significant reduction between preoperative and postoperative score in patients who underwent extra-corporeal decortication septoplasty using PDS plate when compared to the results of those who underwent conventional septoplasty with a p-value of 0.000. CONCLUSION: Extracorporeal decortication septoplasty can be recommended as a suitable alternate in the management of difficult septum where conventional septoplasty may fail to achieve a good functional outcome.