Chemical Ablation of the Septoturbinar Synechia

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2002

Decades have passed since septoplasty was first introduced for the management of the nasal airway. Various modifications of the technique have been made to deal with the pathology of the nasal septum. The authors have used the nasal endoscope successfully for the ultraconservative management of the deviated nasal septum and turbinoplasty [inferolateral partial resection of the turbinate/s]. The present study is an update series of the previously published preliminary series, and comprises of 480 cases of deviated nasal septum who underwent endoscope aided septo-turbinoplasty [EAS] to improve the nasal airway. The subjective assessment of the efficacy of this procedure was done by visual analogue scoring system and the objective assessment was done by endoscopy. This study demonstrates significant improvement in relieving nasal obstruction and the contact areas. The authors advocate a combined approach-an endoscopic approach for inaccessible posterior deviation and a conservative tra...

Journal of Otolaryngology-ENT Research

Objectives: To evaluate functional results and complications of trans-septal suturing compared with nasal packing following septoplasty. Background: Debate still persists about using trans-septal suturing as a safe and useful alternative to nasal packing in septoplasty. This prospective study included 64 patients who presented to ENT outpatient clinics of Menoufia University and Kafr El-Sheikh General Hospitals complaining of persistent nasal obstruction due to septal deviation and underwent septoplasty under general anesthesia from October 2016 till September 2017. Patients were randomly divided into 2 groups; transseptal suturing group (A) and nasal packing group (B), and were assessed for operative time, post-operative hospital stay, complications, and functional outcomes using Nasal Obstruction Symptom Evaluation (NOSE) scale. Results: Operative times were longer in group A (4.094 ± 1.027) than B (1.438 ± 0.416). Post-operative bleeding was more frequent in group A (21.87%) than B (6.25%). Post-operative nasal obstruction (100%), pain (100%), headache (84.38%), epiphora (37.5%), swallowing discomfort (31.25%), sleep disturbances (81.25%), pack removal hazards as pain (87.5%), syncope (25%) and bleeding (25%), local infection (25%), granulation tissue formation (34.37%), synechia (34.37%) and post-operative hospital stay (P<0.001) were prevailing in group B. Septal hematoma, abscess, and perforation were non-significant in both groups. NOSE Scores in both groups pre-and post-operatively showed high significant improvements in all parameters (P<0.001) in group A. Trans-septal suturing is a safe procedure and useful alternative to nasal packing in septoplasty with minor increase in operative time and postoperative bleeding which is easy to control.

Journal of Laryngology and Otology, 2008

Objective: To determine the efficacy of inferior turbinate coblation for the treatment of nasal obstruction. Methods: Twenty patients awaiting submucosal diathermy to the inferior turbinates were recruited into the study. All underwent inferior turbinate coblation. Pre-operative and post-operative nasal function was investigated using posterior rhinomanometry and subjective symptom scales. Results: There was no significant increase in nasal conductance two weeks after inferior turbinate coblation (p ¼ 0.159). However, three months after inferior turbinate coblation, median nasal conductance had increased significantly, from 203 to 324 cm 3 /s (p ¼ 0.004). The median increase in nasal conductance was 73 cm 3 /s or 43.5 per cent. Post-operative visual analogue patients' reported post-operative visual analogue scales scores for nasal obstruction decreased significantly, both two weeks (p ¼ 0.006) and three months after inferior turbinate coblation (p ¼ 0.001) when compared to Preoperative values. There was no change in the reported severity of rhinorrhoea, nasal itching or sneezing. There was a significant relationship (r ¼ 20.57, p ¼ 0.014) between pre-operative nasal conductance and change in nasal conductance after inferior turbinate coblation. Conclusions: This study confirms the short-term efficacy of inferior turbinate coblation for the treatment of nasal obstruction. The benefit was greatest in patients with lower pre-operative nasal conductance. Objective measures of nasal obstruction may be important when selecting patients for inferior turbinate coblation.

Septoplasty is one of the most common otorhinolaryngologic surgical procedure. It is customary to place a pack in the nose as a part of nasal surgery to stop bleeding, enhance apposition of mucosal flaps, and stabilize the operated septal cartilage and bones. But nasal packing is not an innocuous procedure. The most common problem encountered by the patients after septoplasty with nasal pack is the pain and discomfort in post operative period. The study has been performed to compare the complications and outcome of septoplasty with or without nasal packing. Forty four patients were randomly allocated into two groups, Group A (n = 21) and Group B (n = 23). In Group A trans-septal suture and in Group B intranasal pack was used following septoplasty. Both groups were compared for postoperative pain, postoperative complications and surgical outcome. Among 44 patients 31 patients were male and 13 patients were female. Most of the patients ie 79.5% were operated for nasal obstruction. Onl...

Indian Journal of Otolaryngology and Head & Neck Surgery, 2001

International Archives of …

The Egyptian Journal of Hospital Medicine, 2020

Background: Septum deviation is the major cause of nasal obstruction, which is the most common symptom in ENT practice. Surgical correction of the deviated nasal septum has been advanced over the years, from the radical removal of both mucosa and cartilage to submucous cartilage resection with preservation of the mucosa. Objective: To compare the efficacy of the conventional and the endoscopic septoplasty in the management of patients with symptomatic nasal deviation. Patients and methods: This study included 40 patients presented to the Otorhinolaryngology outpatient clinic at Assiut University Hospitals between May 2018 and December 2019, suffering from nasal obstruction due to a significant septal deviation, randomly divided into two groups: Group A: 20 patients underwent endoscopic septoplasty and Group B: 20 patients underwent conventional septoplasty. Results: In this study, no significant difference was detected in the preoperative results of both groups regarding the age, sex and types of septal deformities. So, the preoperative circumstances were similar between both groups. Hence, results of this study showed that these two procedures were suitable to correct septal deformities but the endoscopic septoplasty was superior to the traditional septoplasty in cases with isolated septal spur. Also, it was associated with the minimal re-occurrence rate. Conclusion: Endoscopic septoplasty is a valuable teaching tool, which is efficient in the management of different types of septal deformities.

Introduction: 'Nasal obstruction'-the most common problem faced by people having deviated nasal septum. So study was done to compare the relief of nasal symptoms between Submucosal resection and Septoplasty surgical techniques by relying on SNOT-22 score and to compare the complications of Septal surgery between Submucosal resection and Septoplasty. Material and methods: 50 patients with nasal obstruction were included in the study. Depending on the history and clinical features, anterior rhinoscopy was done to identify nasal septal deviation. Type of surgery used depended upon the type of deviation. Results: In Septoplasty most of the cases had C shaped deviations, where SMR had spurs. The average Pre-operative score for all the nasal symptoms was 10.56 (SD 1.53) compared with a Post-operative average score of 1.20 (SD 1.04). The average Pre-operative score for all the non nasal symptoms was 2.64(SD 1.49) compared with a Post-operative average score of 0.36 (SD 0.49). Conclusion: There was no significant difference between Submucosal resection and Septoplasty with respect to symptomatic relief and complications following the surgery.

Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method Analisi retrospettiva di 697 casi sottoposti a settoplastica: tamponamento nasale versus sutura tran-settale SummAry The trans-septal suturing method has been developed in septoplasty as an alternative to packing. This study was carried out to compare the postoperative results of trans-septal suturing with the anterior merocel packing technique. The study involved 697 patients who underwent septoplasty. Following surgery, patients were randomly divided into two groups, one with trans-septal suturing and the other with merocel packing. Patients were asked to record pain levels using a visual analogue scale. Postoperative symptoms and complications were compared. A total of 697 nasal operations were evaluated in the postoperative period considering pain, bleeding, haematoma, septal perforation synechiae and septal perforation. The results for haemorrhage, haematoma, synechiae and perforation were not statistically different (p > 0.05) between groups. in contrast, the level of postoperative pain in patients undergoing trans-septal suturing was significantly less than in the group who received merocel packing (p < 0.05). Patients with merocel packing had significantly more pain and nasal discomfort when assessed 1 week after intervention. Therefore, the trans-septal suturing technique may be the preferred option to provide higher patient satisfaction.

JPRAS Open, 2019

Septoplasties and septorhinoplasties are common procedures in otolaryngology, aimed at addressing septal and/or bony pyramidal deflections to improve functional and cosmetic outcomes. The nasal septum as well as regulating air flow provides structural support to the nasal tip. The attachment of the nasal septum to the anterior nasal spine must be structurally resilient to prevent saddling or tip ptosis. This can be achieved by direct attachment with absorbable suture material to the periosteum of the anterior nasal spine or a drill fitted with 0.6 mm diamond tip burr (Ultrabur, Invotec International), to create channel through which the nasal spine can be secured to the anterior nasal spine. We describe a novel, and cost-effective alternative utilising a blunt fill needle and simple absorbable suture. A blunt fill needle (Sol-Millenium®, cost £0.03 per unit) is passed through to form a securing channel. The neoseptum is then secured using a figure-of-eight suture. Our novel technique enables the nasal septum to be secured to the anterior nasal spine in a cost effective and efficient manner.

Rhinology, 2010

Nasal packing or trans-septal sutures are used to prevent postoperative complications in septoplasty. Trans-septal suturing is not commonly used, since it takes time and is technically difficult with the available devices following septoplasty. This study included 64 patients who underwent septoplasty. Following septoplasty, the patients were divided into two groups: group 1 had trans-septal sutures placed using a novel device and group 2 had the nose packed with a tampon. The duration of surgery, postoperative symptoms and complications were compared. All of the postoperative symptoms were significantly less in the group with trans-septal sutures. The mean duration of surgery was 34.9 minutes in the nasal packing group and 37.8 minutes in the trans-septal suture group, and the difference was significant (p = 0.026). No postoperative bleeding, submucoperichondrial haematomas, infections or abscesses occurred in any of the patients, whilst nasal perforation was observed in one patien...

International Congress Series, 2003

First proposed in 1991 (Lanza et al.; Stammberger), endoscopic septoplasty is an alternative to conventional and/or microsurgical approaches that permits the correction of septal deviations under excellent visualization and optimal control with minimal trauma. The literature reports numerous advantages to this technique, including better visualization and wider, unobstructed visual field, reduced operation times, more accurate identification of the septal area to be corrected with limited extent of the excision, the possibility of using combined approaches, control of bleeding, more possibilities for limited surgical revision after septoplasty and septal perforations, concurrent surgical endoscopy of paranasal sinuses. Based on our experience, our results from the use of this procedure combined with conventional and/or microsurgery confirm the advantages stated above, especially as regards the enhanced possibility of controlling the segments to be corrected and the limited extent of surgery. Lastly, endoscopic septoscopy can also be considered an effective teaching tool. In fact, when viewed over a monitor, the procedure provides an excellent opportunity for recording and studying anatomy, pathology and surgical techniques in the training of Assisting Surgeons, graduate Specialists and Medical students.

Collegium antropologicum, 2011

Fifty-two patients with inferior turbinate hypertrophy who were refractory to medical therapy were evaluated for coblation. The procedures were performed under local anesthesia using an ArthroCare ReFlexUltra 45 wand; three submucosal channels were made per turbinate. Clinical examinations, a questionnaire on individual nasal symptoms (hyposmia, nasal drainage and post-nasal drip), a 10-cm visual analog scale (VAS) grading general nasal obstructions, and rhinomanometry before and 8 weeks after the treatment were administered to assess treatment outcomes. No adverse effects were encountered. Nasal breathing was significantly improved in all patients, decreasing the VAS from a median of 7 (range 2-9) to 1 (range 0-3) (p<0.001). Total nasal resistance decreased from 0.44 Pa±0.50 to 0.24 Pa±0.11 (p=0.005). Improvement was statistically significant for all three symptoms (hyposmia [p=0.005], nasal drainage [p=0.003] and post-nasal drip [p<0.001]). In this paper, we demonstrate that coblation-channeling of the hypertrophic inferior turbinate is an effective and safe way to reduce nasal obstruction symptoms.

Otolaryngology -- Head and Neck Surgery, 2000

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2016

Septal and turbinate surgeries are often performed concurrently for nasal obstruction, yet the causative pathology for each structure becoming symptomatic can usually be attributed to structural deformity and mucosal problems respectively. This article is protected by copyright. All rights reserved.