Indications and Functional Results of Septoplasty – Results
of a Prospective Study
Kučerová D., Vrabec P., Kuchynková Z.
Klinika ORL a chirurgie hlavy a krku 1. LF UK, Praha, katedra otorinolaryngologie IPVZ, Praha, přednosta prof. MUDr. J. Betka, DrSc. |
|
Summary:
S u m m a r y: Irregularity of nasal septum occurs in 80% of population, but not all of them re of
functional significance. The paper presents the results of a prospective study aimed at evaluation
of correct indication for septoplasty,which should differentiate,whether nasal obstruction is caused
by is caused by irregular nasal septum or mucosal changes in nasal cavity, to determine significance
of individual types of septum deformities in nasal obstruction with the use of rhinomanometry
compared with subjective evaluation and to measure functional effect of seroplasty. The group
included 63 examined patients (48men, 15women at the average age of 32 years),whowere indicated
for septoplasty by common methods of examination (anterior rhinoscopy, case history). Forty
patients showed up for the measurement after the surgery. The objective examination of nasal
patency was tested by the rhinomanometric device ATHMOS 300. The mean value of nasal resistance
(R) before the operation on the examined patients was 0.7 before the anamization and 0.4 after
the anemization. This value is almost three-fold higher than normal values.However, normal values
of nasal resistance R up to 0.25 were observed in 12 patients (20%). A subjective improvement of
nasal patency after the operation was reported by 36 patients (90%), remaining unchanged in the
remaining four subjects. The resulting value of nasal resistance of the whole group after the
operation was 0.33 before anemization and 0.28 afterwards. It did not reach physiological values,
but came close to them. The mean values of nasal resistance of the whole group improved by 55%.
In the 40 surgically treated patients, normal values of R < 0.25 were established in 21 (52 %) only, all
of them being satisfied with the outcome. In the other 19 (48%) patients, 15 subjected were satisfied
with the results. However, objective improvement was reached in 52% of examined subjects only in
contrast to 90% of patients being satisfied from subjective point of view. In the group of patients
where objective improvement of R was established, there were no subjects considering the effect as
insufficient. This discrepancy was mostly due to patients with allergic rhinitis who experienced
subjective improvement of nasal patency in spite of lasting rhinitis, although the objective values
of nasal resistance did not changed significantly. The group with allergic rhinitis and a small septum
deformity represents a most controversial indication for septoplasty. The best improvement after
the operation became obvious in patients with posttraumatic septum deformity who represented
most of the group. Rhinomanometric examination contributed to correct selection of patients for the operation especially in controversial cases, when clinical examination did not correlate with
subjective complaints of the patient.
Key words:
septoplasty, nasal septum, rhinomanometry, nasal resistance.
|