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Septal Surgery (septal + surgery)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Biomechanical Strength of Human Nasal Septal Lining: Comparison of the Constituent Layers

THE LARYNGOSCOPE, Issue 8 2005
David W. Kim MD
Abstract Objective/Hypothesis: Nasal septal perforation is a common complication following surgery involving the nasal septum. Septoplasty, septorhinoplasty, and submucosal resection may result in the inadvertent resection of perichondrium, which may predispose the patient to septal perforations. Study Design: Controlled human cadaver study testing the biomechanical strength of the constituent layers of nasal septal lining. Methods: Uniform samples of nasal septal mucosa, perichondrium, and a composite of both layers were obtained from five fresh human cadavers. The mechanical tensile strength of these layers was evaluated and compared with the Instron 4301 Mechanical Testing System (Canton, MA). Results: Mixed-effects regression analysis demonstrated a significant difference in the tensile strength of the three groups (mean values ± SD: mucosa, 662 ± 308 g; perichondrium, 1370 ± 798 g; composite, 2340 ± 1252 g). All three pairwise comparisons among the three groups showed a significant difference in tensile strength. Conclusion: The perichondrial layer imparts the majority of the biomechanical strength to septal lining. Lining flaps containing both perichondrium and mucosa are stronger than flaps with either perichondrium or mucosa alone. Dissection in the subperichondrial plane during septal surgery provides a stronger septal flap and may prevent the development of nasal septal perforation during nasal surgery. [source]

Assessment of subjective scales for selection of patients for nasal septal surgery

CLINICAL OTOLARYNGOLOGY, Issue 4 2006
J.M. Boyce
Objective:, To investigate the use of subjective measures to assist the surgeon in patient selection for septal surgery. Study design:, Prospective, observational. Approved by local ethics committee. Setting:, ENT outpatient department, University Hospital of Wales. Participants:, Forty-six participants on the waiting list for septal surgery for nasal obstruction. Main outcome measure:, Measurement of nasal partitioning of airflow by rhinospirometer (GM Instruments, Scotland), subjective scales, and investigator's assessment of septal deviation. Results:, The subjective scores, and investigator's assessment of septal deviation, were compared with the rhinospirometer objective measurements for correlation, sensitivity and specificity. The rhinospirometry results showed that 20% of the patients on the waiting list had objective measures of partitioning of nasal airflow within a normal range for healthy subjects. The ordinal scale proved to be more useful than the visual analogue scale for patient selection. The subjective scores of airflow partitioning from the double ordinal scale correlated well with the rhinospirometry measurements (r = 0.8). The ordinal scale also had a sensitivity of 81% and a specificity of 60%. The investigator's subjective assessment of septal deviation had a high sensitivity at around 100% but had a lower specificity (30%). Conclusions:, The use of a subjective ordinal scale to measure partitioning of airflow greatly increased the specificity of patient selection and it is proposed that this scale may be useful to the surgeon when assessing patients for septal surgery. [source]

A randomised clinical trial of turbinectomy for compensatory turbinate hypertrophy in patients with anterior septal deviations

CLINICAL OTOLARYNGOLOGY, Issue 6 2000
D A. Nunez
Turbinectomy is performed at the time of nasal septal surgery by many otolaryngologists. One reason given for this procedure is the presence of a hypertrophied contralateral inferior turbinate. A randomised trial was undertaken to evaluate the relief of nasal obstruction following contralateral turbinectomy with septal surgery. Patients presenting with nasal obstruction who had a unilateral septal deviation and contralateral inferior turbinate enlargement were prospectively randomized to contralateral turbinectomy or no turbinate surgery at the time of septal surgery. Questionnaires and active anterior rhinomanometry were used for evaluation. Twenty-six patients (mean age 31 years) demonstrated a reduction in subjective and objective measures of nasal obstruction (P < 0.05) 8 weeks after operation. There was no intergroup difference, the median total decongested nasal resistance postoperatively in the non-turbinectomized patients was 0.17 kPal,1 s and 0.21 kPal,1 s in the turbinectomized patients. Contralateral inferior turbinectomy does not add to the relief of nasal obstruction beyond that attained by septal surgery in these patients. [source]