Comparison of Endonasal and External Septoplasty for Treatment of Buckled Caudal Septal Deviation.

ABSTRACT

OBJECTIVE: To compare endonasal and external septoplasty for type 2 caudal septal deviations in terms of operative time, aesthetic and functional outcome. STUDY DESIGN: Descriptive Analysis. PLACE AND DURATION OF STUDY ENT Department, Mayo Hospital/ K.E.M.U, Lahore, from October 2019 to October 2020. METHODOLOGY: Record of patients operated for septal deviations in 2019 were retrospectively reviewed. All patients, diagnosed with type 2 caudal septal deviations, were included; while those with marked inferior turbinate hypertrophy, deviated nasal septum after trauma, and those who could not be followed-up, were excluded. Twenty-eight patients, operated by external approach, were placed in group A; and 32 patients, who had endonasal surgery, were placed in group B. Functional outcome was assessed by nasal obstruction symptom evaluation (NOSE) scale; and cosmetic deformity was assessed by visual analog scale (VAS) pre- and postoperatively at six months. Operative time was measured for both the groups. RESULTS: Sixty patients were included. Mean preoperative NOSE scale score for group A was 67.36 ± 8.07 and postoperative was 15.82 ± 3.62 (p<0.001). Mean preoperative NOSE score for group B was 69.40 ± 5.80 and postoperative it was 18.00 ± 3.75 (p<0.001). Mean VAS score for group A preoperative and postoperative was 18.93 ± 7.86 and 76.07 ± 6.85 (p<0.001), respectively. Mean VAS score for group B preoperative and postoperative was 19.69 ± 7.82 and 71.56 ± 8.84, respectively (p<0.001). Mean operative time for group B was 52.25 ± 3.37 minutes, and for group A 115.00 ± 9.91 minutes (p<0.001). The difference in preoperative and postoperative NOSE and VAS scores compared for both groups revealed p-value of 0.952 and 0.044, respectively. CONCLUSION: Extracorporeal septoplasty resulted in better aesthetic outcome; though endonasal septoplasty had shorter operative time. Both surgical techniques resulted in good functional outcome. Key Words Nasal septum, Nasal surgical procedures, Deviated nasal septum, Caudal deviation septum, Septoplasty,  Septorhinoplasty, Nasal obstruction symptoms evaluation (NOSE) score, Visual analogue scale (VAS).