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Background:
The present study was performed to compare postoperative success and patient satisfaction among patients with septum deviation according to deviation type.
Methods:
Eighty-six patients with septal deviation were recruited and divided according to six deviation types as defined previously. Patients were followed up for a mean duration...
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Context 1
... were classified into six groups based on the type of septal deviation as defined by Baumann et al. based on their analysis of 1088 patients 10 (Fig. 1). The nasal cavity with the septal deviation was designated as the narrow cavity, and the contralateral side was des- ignated as the wide cavity; results were reported ...
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Introduction
The complaint of nasal obstruction or difficulty in nasal breathing is highly subjective.
Benefits of Septoplasty, as perceived by the patient, also varies widely with subjective satisfaction ranging from complete alleviation of symptoms to a total failure.
Materials and Methods
Fifty three patients above 18 years of age, with anat...
Citations
... Most common type of septal deformity was type 1 Baumann's classification of deviated nasal septum in both group 1 with 10 cases (40%) and group 2 with 13 (52%) cases in the present study. It is in accordance with a study done by Eren et al. [8] which had the type 1 deformity as the most common type, with 22 cases out of 86 having the same. ...
Deviated nasal septum (DNS) causes nasal obstruction, secretions, decreased sense of smell, bleeding, headache and snoring. This study aims to compare endoscopic-assisted septoplasty versus conventional septoplasty in terms of surgical outcome and intra- and post-operative complications. A prospective study was done on 50 patients aged between 18 and 41 years of which, 41 (82%) cases were males and 9 (18%) were females who had DNS based on clinical examination and diagnostic nasal endoscopy. Patients were randomized by simple randomization into two groups. Functional outcome was assessed using nasal surgical questionnaire (NSQ) prior to and after surgery for 3 months post-operatively and complications associated with the surgery were compared between two groups. In this study, most of the patients had anterior dislocations, present in 37 cases (74%). Improvement in pre- to post-operative visual analogue scale (VAS) for nasal obstruction was significantly better in endoscopic-assisted than conventional septoplasty (p < 0.001*). Pre-and post-operative differences in 4-point likert scale for other nasal symptoms like decreased sense of smell, snoring, secretions, headache and crusting were better in endoscopic-assisted septoplasty (p < 0.001*). Complications in endoscopic-assisted septoplasty were less common compared to conventional septoplasty (p = 0.05). In endoscopic-assisted septoplasty patients, pre-to post-operative NSQ (Nasal Surgical Questionnaire) VAS improvement for nasal obstruction, likert scale change from pre-to post-op were better and complications were lesser compared to conventional septoplasty. This suggests endoscopic-assisted septoplasty has better surgical outcomes and fewer complications and posterior deviations, spurs and inferior deviations can be corrected with ease and fewer complications.
... Philip et al in his study used modification in NOSE scale to address all these symptoms and to address a wider range of symptomology which included snoring, poor sense of smell, feeling panicky enough that air is not entering the nose, irritation in the throat, nocturnal cough, daytime sleepiness, frequent common cold, general health condition, blocked sensation in ear, headache and epistaxis. 12 Eren et al studied objective evaluation of septal deviation post septoplasty by classifying septal deviation into six groups using classification defined by Baumann et al. 13,14 Mladina et al in his study classified the anatomical septal deviation of nasal cavity into seven types and named it as Mladina's classification of septal deviation. 15 ...
... 20 Eren et al reported that there was a significant improvement in the Visual analogue scale and NOSE scores post septoplasty. 13 In our study we measured the objective outcome by categorizing the patients post operatively into four groups. These were completely corrected anatomical deviation, partially corrected deviation, deviation not corrected and deviation aggravated with complications. ...
... His study revealed that there was significant improvement in all the parameters post septoplasty. 13 We went a step ahead in our study and tried to correlate the subjective and objective outcomes of septoplasty. Mean score of modified NOSE score preoperatively was compared with postoperative mean score and was correlated in every single group of improvement categorised on basis of diagnostic nasal endoscopy in all the types of patients. ...
p> Background: Septal deviation is one of the leading causes of chronic nasal obstruction. Septoplasty is the procedure of choice for treating these patients. Depending on the patient’s perception and satisfaction the benefits of the surgery vary.
Methods: A prospective study was conducted at command hospital air force Bangalore in the department of ENT for a period of 2 years from 2018 to 2020 in 60 patients who underwent septoplasty. Preoperative and postoperative data were documented and analysed to get the results.
Results: On postoperative objective evaluation by diagnostic nasal endoscopy 47% of patient’s anatomical deviation was completely corrected while it was partially corrected in 53% of patients overall. Post-op subjective evaluation by evaluating mean modified nose obstruction symptom evaluation (NOSE) score also depicted a significant improvement (p<0.5). There was also a significant positive correlation between the subjective and objective outcomes of septoplasty in our study. On correlating the postoperative subjective and objective outcome individually in all the types of septal deviation, there was an improvement in mean modified NOSE score in all types of patients.
Conclusions: There was improvement in both subjective and objective outcomes postoperatively. Study concluded that modified NOSE scale addresses wider range of symptomatology and is a good tool for subjective assessment of septoplasty. Improvement in anatomical septal deviation was noted by diagnostic nasal endoscopy postoperatively in all types of septal deviation of patients in our study.</p
... The improvement in bilateral PNIF values after septoplasty is similar to one report [12] but lower than in another [15]. The degree of improvement in bilateral PNIF ratings in septoplasty with turbinoplasty was similar to several other studies [18,19] and also to studies on septorhinoplasty [16,20]. In our study, the overall mean preoperative bilateral PNIF score was lower than the reference value of 120 L/min considered discriminative between obstructive and normal value [7], while the mean postoperative PNIF value was well above this reference. ...
Objectives: The aim of this study was to explore the subjective and objective measurements in assessing before and after nasal septoplasty with and without turbinoplasty surgery. Methods: This was a hospital-based pre and post clinical trial study of 80 patients with nasal septal deviation treated with nasal septoplasty with or without turbinoplasty in 2019- 2020. Nasal patency was recorded subjectively and objectively before and 2.5 months after surgical treatment using a visual analogue scale (VAS), nasal obstruction symptom evaluation (NOSE), sino-nasal outcome test (SNOT-23) questionnaires, peak nasal inspiratory flow (PNIF) measure and internal nasal valve (INV) grading. Results: Nasal septoplasty (38 patients) and septoplasty with turbinoplasty (42 patients) were performed on 80 patients (60 males; 20 females) with a mean age of 37.5 years. The results showed a significant improvement of nasal passage condition in scales of VAS, NOSE, SNOT-23, as well as INV grading, and PNIF values after surgery. Septoplasty with turbinoplasty showed greater improvement in VAS and PNIF scores than septoplasty alone and this was even more significant for bilateral PNIF scores. Conclusion: We found VAS, NOSE, INV grading and PNIF measures to be reliable instruments in reporting results of surgery.
... Type 6 is characterized by unilateral, horizontal gutter in the anterior and basal septal parts. Type 7 is very variable and can consist of various combinations and is almost always bizarre [4]. Lately, studies have revealed the role of septoplasty in curing CRS in patients with significant septal deviation. ...
Background
Chronic rhinosinusitis represents an important health care problem in the world. Deviated nasal septum leads to increased chance of impaired mucociliary clearance, osteomeatal complex obstruction, and development of rhinosinusitis. Studies have revealed the role of septoplasty in curing chronic rhinosinusitis in patients with significant septal deviation. The purpose of this study is to reveal the role of septoplasty alone or combined with functional endoscopic sinus surgery in improving the outcome of chronic rhinosinusitis in patients with significant septal deviation.
Results
Postoperative computed tomography findings in group A (underwent septoplasty only) were mild opacity of ethmoid (25%), sinus mucosal thickening (15%), and occluded osteomeatal complex with discharge (25%). Postoperative computed tomography findings in group B mild opacity of ethmoid (30%), sinus mucosal thickening (20%), and occluded osteomeatal complex with discharge (30%). The Sino-Nasal Outcome Test score in group A decreased significantly from 85.75 to 28.85 ( P < 0.05). In group B (underwent combination of septoplasty and functional endoscopic sinus surgery), the Sino-Nasal Outcome Test score also decreased significantly from 87.75 to 32.55 ( P < 0.05). The improvement was 85% in group A and 80% in group B.
Conclusion
The post-operative improvement has no significant difference between the two groups. Hence, we suggest that septoplasty alone can be adequate for the treatment of chronic rhinosinusitis with septal deviation.
... To the best of our knowledge, this represents the first instance of a deviated septum presenting as a wavy structure in an amniote. Septal deviations more typically present as a singular incursion into one nasal passage (Eren et al., 2014;Peralta et al., 2017) rather than the alternating compression of both nasal passages as we observed here ( Figure 18). Although nasal septum deviation was witnessed in both Taj and Louise, the degree of septal deviation was much larger in Louise and had distinct physiological ramifications. ...
The remarkably thin rostrum in the Indian gharial (Gavialis gangeticus) imparts challenges to nasal physiology. Competition for space in the slim jaws necessitates a thin nasal septum, leaving this taxon susceptible to nasal passage abnormalities such as septal deviation. Here we describe the nasal anatomy of gharials based on multiple individuals including one that showcases an extreme instance of nasal septum deviation. We found that gharials have both confluent nostrils and choanae, which may be important for their unique nasal acoustics. The deviated nasal septum in the female showed distinct waviness that affected the nasal passages by alternately compressing them. We performed a computational fluid dynamic analysis on the nasal passages to visualize the effects of septal deviation on airflow. Our analysis found the deviated septum increased nasal resistance and wall shear stress during respiration, resulting in unequal distribution of the air field between both sides of the nasal passage. Our findings indicate that gharials—and potentially other longirostrine crocodylians—may be particularly susceptible to septal deviations. Lastly, we observed pterygoid bullae to be present in both sexes, though their morphology differed. Airflow in the male pterygoid bullae produced a Bernoulli effect which may be responsible for the unique “pop” sounds recorded in this species.
... Quality of life and patient satisfaction in septoplasty B-ENT 2021 Evaluation of correlation between patients' quality of life and satisfaction levels The success of surgical treatment can be determined by differences or compatibilities between objective and subjective results (29). The disease symptoms can be completely eliminated or reduced as a result of the treatment method selected; however, when there is no patient satisfaction, the desired surgical success will not be achieved (30). ...
... The disease symptoms can be completely eliminated or reduced as a result of the treatment method selected; however, when there is no patient satisfaction, the desired surgical success will not be achieved (30). Therefore, objective and subjective methods should be used together in preoperative and postoperative evaluations (29). In our study, the healthcare satisfaction level increased as the postoperative nasal congestion symptom scores decreased (as the disease-specific QOL level increased) in patients who underwent GA and LA. ...
Objective: Several studies in literature have reported the effects of septoplasty on postoperative quality of life. However, there is not enough evidence regarding the effect of the chosen type of anesthesia on patient satisfaction and quality of life in patients with septoplasty. In this study, we aimed to evaluate the effect of anesthesia in patients who underwent surgery for nasal septum deviation on their quality of life (QOL) and patient satisfaction. Methods: This prospective, non-randomized, and controlled study was conducted in a third-line reference hospital between July and December 2016. Although no randomization technique was used in the study, the patients included in the study were those on the clinical surgery list and met the inclusion criteria. Fifty patients who underwent septoplasty under general anesthesia (GA) and 50 who underwent septoplasty under local anesthesia (LA) were included. Data were collected using a case report form, World Health Organization-5 (WHO-5) Well-Being Index, Nasal Obstruction Symptom Evaluation (NOSE) form, and patient satisfaction form. Data collection from the completed forms was blinded to the patients and type of anesthesia (day of surgery and post-op 30 th day). Descriptive statistics, Mann-Whitney U test, Pearson's chi-squared test, Wilcoxon marked order test, and Spearman's correlation test were used for data evaluation. Results were evaluated based on 95% confidence interval and p value of < 0.05. Results: There was no difference in sociodemographic characteristics of patients and median WHO-5 and NOSE scores between the groups (p > 0.05). Postoperatively, there was no difference in general health, QOL, and satisfaction (p > 0.05); healthcare satisfaction was higher in patients who had GA (p = 0.000). Conclusion: There was no significant difference in QOL between the patients who underwent septoplasty under GA and LA. In the first month following surgery, patients who underwent septoplasty under GA had higher healthcare satisfaction.
... Most studies that evaluated subjective and objective parameters on DNS patients with nasal obstruction were observational or retrospective in nature or involved different types of surgical procedures and were performed with much smaller sample sizes. [23][24][25] In septoplasty, DNS is straightened, causing a widening of the nasal passages. This results in improved ventilation and inspiratory effort in patients with nasal obstruction. ...
Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven.
Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management.
Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups.
Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p = 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p = 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p = 0.001).
Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.
... 한 절제나 조작이 어렵다는 점 때문이다. [7][8][9] 그간 비중격 미부의 교정을 위해서 많은 연구와 시도 가 진행되어 왔고, 저자들도 부분 절단 봉합술을 고안하 여 우수한 결과를 보고하였다. 10 ...
... Type 6 is characterized by unilateral, horizontal gutter in the anterior and basal septal parts. Type 7 is very variable and can consist of various combinations and is almost always bizarre [4]. Lately, studies have revealed the role of septoplasty in curing CRS in patients with significant septal deviation. ...
... In a study conducted by Eren, it was reported that the VAS and NOSE scores of 86 patients with nasal obstruction had significantly decreased 3 months after Septoplasty [16]. ...
Septal Correction is an age-old procedure being practiced for the major part of a century now. The aim of this study was to assess the quality of life after Septal Correction. Fifty patients with complaints of nasal obstruction, trouble breathing via the nose, headache and facial pain were selected for the study. Initial pre-operative assessment was done based on a symptomatic score [Nasal Obstruction Symptom Evaluation Scale (NOSE Scale)]. The presence of a septal deviation was confirmed with an X-ray and computed tomography of the paranasal sinuses along with a diagnostic nasal endoscopy. Based on the extent and location of deviation, the malformed part was corrected. Post-operative assessment was done after a period of 8 weeks based on the NOSE Scale. The results were co-related and documented. It was found that the scores were better post-surgery. Thus, it can be concluded that Septal Correction as a surgical procedure is still relevant in today's World for symptomatic betterment and for a healthier lifestyle.
