Evaluation of the inferior turbinate in patients with deviated nasal septum by using computed tomography

OBJECTIVES/HYPOTHESIS: The objective was to measure the dimensions, composition, and possible structural and radiological changes of the compensatory hypertrophic inferior turbinate in patients with deviated nasal septum. STUDY DESIGN: A prospective, nonrandomized clinical trial at a university medical center. METHODS: Twenty-three patients with deviated nasal septum and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity were examined by computed tomography. RESULTS: The dimensions of the compensatory hypertrophic inferior turbinate in patients with septal deviation were compared with normal control subjects. The difference in width of the medial and lateral mucosa and the conchal bone between the two groups was statistically significant (P <.05). CONCLUSION: The present study uncovers the dimensions and composition of the inferior turbinate with compensatory hypertrophy in patients with nasal septum deviation. The findings support the decision to excise the inferior turbinate bone at the time of septoplasty, because of the significant bony and mucosal expansion.     

Comparative evaluation of endoscopic with conventional septoplasty

A study was conducted to assess the merits and demerits of endoscopic septoplasty. Fifty patients having symptomatic DNS were randomly divided into two groups of 25 patients each. One group underwent endoscopic septoplasty and other group underwent conventional septoplasty. The groups were compared regarding the complaints with pack in postoperative period, relief of symptoms after surgery and complications. The symptoms complained by the patients with pack in postoperative period and complications after surgery were significantly less in endoscopic septoplasty group.     

Aesthetic sequelae of septoplasty

This prospective study, using standardized pre- and post-operative photographs examined by three independent observers, included 100 septoplasty patients with a minimal follow up of 9 months. A risk of minimal aesthetic changes (21%) could be documented, but significant post-operative changes (1%) were rare. Surprisingly, statistical evaluation of operative data in relation to aesthetic changes could not identify specific surgical manoeuvres which may increase the risk of aesthetic changes. All patients must be fully informed about possible changes in nasal shape as a result of septoplasty. Pre-operative photographs should be considered a prerequisite before any type of septal surgery.     

Extracorporeal septoplasty-how we do it at marienhospital stuttgart germany

Septoplasty is one of the most common surgery of ENT but even today the difficult septum still presents a great surgical problem. A severe septum deformity is usually due to an accident quite often in childhood. It is also seen in patients with malformation such as cleft lip and cleft palate deformity. It affects not only the nasal function, but also the aesthetic part of the nose. Severe septal deformities can not be corrected properly by the standard septoplasty techniques. Therefore in such cases an extracorporeal septoplasty is recommended. In this technique the whole septum is taken out, the bony and cartilaginous septum in one piece if possible, a new septal plate is reconstructed by different surgical techniques, followed by replantation and reconstruction of the cartilagenous dorsum. The first author kept on improving the safe septal fixation, rebuilding of cartilagenous dorsum and overall the extracorporeal septoplasty technique over the period of time and this technique with all its refinement can be recommended to all the surgeons dealing with this challenging noses.     

鼻中隔棘突激光切除术

目的：研究鼻中隔棘突激光切除术的疗效。方法：52例鼻中隔棘突患者通过激光手术纠正鼻中隔棘突,术后进行疗效评估。结果：50例鼻塞患者中,术后46例（92.0%）治愈,4例（8.0%）好转。32例头痛患者中28例（87.5%）头痛视觉模拟评分改善了50%以上,其中9例头痛完全缓解,4例头痛评分效果改善不到25%。随访发现鼻中隔创面可在1个月内完全自行修复,所有患者均未发现有鼻中隔穿孔、脓肿,脑脊液漏等并发症发生。结论：鼻中隔棘突激光切除术视野清晰,操作简单,出血少,并发症少,费用低,患者术后痛苦小。     

Modified nasal specula and flexible holder for endoscopic nasal surgery

The use of an endoscope in nasal surgery has now extended to surgery on the nasal septum as well as to sinus surgery. We devised the use of the modified nasal specula with Yasargil's flexible holder to resolve the technical problems in using an endoscope for septal surgery. One nasal speculum has two plates for connecting to the Yasargil's flexible holder. This speculum allows the surgeon to use both hands freely and also functions as a guide for stabilizing an endoscope. Another nasal speculum has two long adjustable wings. This speculum can widen the working space between the cartilage or bone of the nasal septum and detached mucosa. Our modified nasal specula are readily applicable to resolve the problems such as unstable endoscope and narrow working space in septal surgery under endoscopic view.     

Comparative study of endoscopic aided septoplasty and traditional septoplasty in posterior nasal septal deviations

Patients with deviated nasal septum are advised surgery, which has seen several modifications since its inception. This recent technique of using nasal endoscopes gives better illumination and access to posterior septal deviations. The aim of the study was to identify the nasal septal pathology in relation to lateral nasal wall in a precise way and to correct this with minimal exposure, limited manipulation and least resection. Twenty five patients underwent endoscope aided and 25 conventional septoplasty. Results were graded on subjective and objective improvement. Endoscopic aided septoplasty (Otolaryngol Head Neck Surg, 1999; 120, 678; Laryngoscope 1994, 104, 1507; J Laryngol Otol 1998, 112, 934; Ear Nose Throat J 1997, 76, 622) was found to be safe, effective and conservative approach with better patient compliance, shorter recovery time and greater stability of remaining septum.