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Jaafer M.K.Al-hassani Qusay Nafi Khalaf Firas Jasim Mohammed

Abstract

Background: A significant percentage of patients undergone endoscopic sinus surgery has septal deviation, that  disturb adequate access to the osteomeatal complex or to the region of axilla  of the middle turbinate. The good exposure is the most important  key to a successful surgery. Straightening such a deflection improve the access to the work site on the lateral wall of the nasal cavity.


Objective: To compare the  peri and post operative complications between conventional  septoplasty (cottle's method) and the endoscopic posterior limited septoplasty in endoscopic sinus surgery.


Patients and Methods: Forty patients (all of them had a limited posterior nasal septal deviation ,nasal and paranasal sinus pathology in addition to  septal deformity),were selected and divided randomly into two equal groups, (by  the type of surgery for septal correction. group A  which underwent  conventional (Cottle's septoplasty), while group B  that had  endoscopic type septoplasty). All patients were assessed in the otolaryngology  department in AL- Immamain Al khadimain medical city, from October 2016 to November 2017.patients were evaluated pre and post operatively by  clinical and endoscopical examination, and followed in a period of 1week, 1month and 3months post operatively.


Results: Functional endoscopic sinus surgery  was the most primary surgery done, followed by Dacrocystorhinostomy and Endoscopic sphenopalatine artery ligation .Most common intraoperative complication  was mucosal flap tear which observed more in conventional group, .Regarding mean operative time for limited septoplasty it was shorter in endoscopic group .Synechia and delay wound healing as a post operative complication was more in endoscopic group, while hematoma and perforation was more in conventional group.


Conclusion: During endoscopic sinus surgery, limited posterior septal deviation can be corrected by endoscopic method which provides better direct visualization of the deviation, more conservative surgical manipulation, shorter in time and less intra and post-operative complications.

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