Deviated nasal septum is the most common cause of nasal obstruction and is one of the common problems encountered by otolaryngologists. Although there are different methods to surgically correct a ...deviated nasal septum which can give qualitative relief to the patient, less emphasis is put on the quantitative assessment of airway after a septal correction surgery. Institution based Case Control study was undertaken at Medical College and Hospital Kolkata between January 2019 to March 2020 to subjectively and objectively assess and compare the nasal airway status preoperatively and postoperatively in patients undergoing conventional and endoscopic septoplasty. A total of 250 patients were taken in this study and divided into two groups A and B. Group A consisted of patients undergoing Conventional Septoplasty (Control arm) and Group B consisted of patients undergoing Endoscopic Septoplasty (Case arm). Patients were followed up and the readings of NOSE score and PNIF value were recorded at the end of 6 weeks and 6 months (24 weeks). The Mean NOSE score post operatively at the end of 6 weeks was 36.32 in GROUP A (Control arm) and 33.08 in GROUP B (Case arm). t-Test revealed insignificant results with a
p
-value of 0.08. The mean NOSE score post operatively at the end of 6 months was 29.96 in GROUP A (Control arm) and 22.16 in GROUP B (Case arm). t-Test revealed significant results with a
p
-value of 0.00. Similarly, Mean PNIF value post operatively at the end of 6 weeks was 57.24 in GROUP A (Control arm) and 73.88 in GROUP B (Case arm). t-Test revealed significant results with
p
-value of 0.00. The mean PNIF value post-operatively at the end of 6 months was 59.44 in GROUP A (Control arm) and 80.08 in GROUP B (Case arm). t-Test revealed significant results with
p
-value of 0.00. Endoscopic Septoplasty is a very effective way to treat septal deviations especially with deviations based on the posterior aspect of the septum. It provides a superior edge in terms of nasal airway improvement as compared to conventional method of septoplasty.
The aim is to investigate the contribution of the PNIF test in daily clinical practices in the objective evaluation of the early postoperative functional results of septoplasty and the effect of the ...severity, direction, and type of nasal septum deviation on mean PNIF values. Nasal septum deviation (NSDs) of the cases were grouped according to the Mladina classification and the severity of NSDs. An objective evaluation of the nasal airway was conducted via a peak flowmeter device in the preoperative and postoperative first month. When examining the mean PNIF values according to genders, it was observed that the values determined in male cases in the preoperative and postoperative period were higher. In the intragroup evaluation performed according the Mladina classification, a statistically significant increase was observed in the preoperative and postoperative PNIF values of the cases in Types 1–4. In the intragroup evaluation performed according to the severity of NSD, there was a significant increase in the preoperative and postoperative PNIF values of the mild and moderate cases. When comparing the preoperative and postoperative PNIF values of the groups in terms of the severity of NSD, it was observed that there was a significant difference. The PNIF can be used in routine clinical practices to evaluate the septoplasty results objectively. In the evaluation of functional results, the change in the mean PNIF values may also vary according to the direction and severity of septum deviation and the Mladina classification other than age, gender and ethnic origin.
Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic ...rhinometry measurements in terms of changes in smell function and the effects on quality of life.
Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography.
The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P < 0.05). The total smell score values in septum group were significantly lower than those of the control group (P < 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P < 0.05).
The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction.
Background
Endoscopic septoplasty has become the preferred choice for septal surgeries for most surgeons due to its precise manipulation and reduced wear and tear. However, the improvement of the ...airway may vary depending upon the type of septal deviation the patient presents with. Cottle in 1946 stated that just mere dealing with deviated septum alone would not ensure a good functional outcome and he further emphasized on addressing portions of the nose obstructing nasal airflow during surgery. The purpose of our study is to subjectively and objectively assess the effectiveness and corrective extent of endoscopic septal correction in different types of septal deviations (Mladina classification) using NOSE scores and Peak Nasal Inspiratory Flowmetry (PNIF). A prospective cross-sectional study was conducted in 87 patients presented in our department from July 2021 to June 2022 for endoscopic septoplasty.
Results
Post-surgery 1-month follow-up (N1), the correction in terms of NOSE scores was highest in Mladina IV and least in Mladina I deviations, and at the end of 3 months (N2), the correction was best recorded in Mladina VI deviations while the least remained in Mladina I. Similarly, PNIF 1-month follow-up (P1) result had the best correction in the Mladina IV and V groups with the least in Mladina I. 3 months of follow-up (P2) ended up showing a maximum improvement in the Mladina VI group. Paired
t
test values for improvement of NOSE and PNIF scores were significant (
p
value < 0.001) between preoperative, 1-month, and 3-month follow-up values and also for repeated measure ANOVA.
Conclusion
Our study reveals that the corrective power of endoscopic septoplasty differs with respect to different types of septal deviation in terms of nasal airflow, both subjectively and objectively. Thus, proper counseling and preoperative assessment is essential for better postoperative outcome and compliance.