The role of limited septoplasty during functional endoscopic sinus surgery for chronic rhinosinusitis

Abstract

Functional endoscopic sinus surgery (FESS) has been the most common surgery for chronic rhinosinusitis (CRS), and to accomplish surgical goals such as facilitate adequate visualization and allow room for endoscopic instrumentation, the correction of the minimally deviated septum has been advocated. Objective: To ascertain the role of limited septoplasty during functional endoscopic sinus surgery (FESS) in reducing the recurrence of the rhinosinusitis. Patients and methods:A prospective descriptive study conducted at the department of Otorhinolaryngology–Head & Neck surgery (Sulaymaniyah Teaching Hospital - College of Medicine - University of Sulaymaniyah). Patients were presented with refractory CRS, with concomitant septal deviation, and prepared for FESS were randomly divided into two groups; group A (10 patients) underwent FESS without septoplasty and group B (10 patients) underwent FESS with limited septoplasty. To determine the effectiveness of the septoplasty in concomitant with FESS, a comparison of the outcomes of FESS in both groups been done throughout utilizing the Sino-Nasal outcome test (SNOT-22) and Lund –Kennedy (LK) endoscopic score preoperatively and 6 months postoperatively. Results: Among the twenty patients included in this study, (40%) of patients in the group A and (30%) of patients in the group B had polyp extending to nasal cavity with (two score), which diminished to 0% at 6 months postoperatively. Need to blow nose, Sneezing, Runny nose, cough, postnasal discharge, ear fullness, dizziness, ear pain, facial pain/pressure, fatigue, sad, embarrassed symptoms had improved in patients undergone FESS with limited septoplasty. Conclusions: Limited septoplasty is primarily used when the septal deviation is located opposite the work area for endoscopic sinus surgery--namely, opposite the middle turbinate and/or the osteomeatal unit.