The impact of pre-operative computed tomography scan in patients underwent septoplasty on the postoperative complications

Authors

  • Abdulwahid S. AlQahtani Department of ORLHNS, Khamis General Hospital, Asir, KSA
  • Ramzi M. Dagriri Department of ORLHNS, Military Hospital of Southern Region, Jizan, KSA
  • Radeif E. Shamakhi Department of ORLHNS, Prince Mohammed Hospital, Jizan, KSA
  • Ahmad M. Alrasheed Department of ORLHNS, Khamis General Hospital, Asir, KSA
  • Ahmed A. Etwadi Department of ORLHNS, Khamis General Hospital, Asir, KSA
  • Khalid A. AlQahtani Department of ORLHNS, Khamis General Hospital, Asir, KSA

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20211001

Keywords:

Computed tomography, Septoplasty, Surgical intervention, Deviated septum, Complications

Abstract

Background: Deviated nasal septum (DNS) is one of the most frequent causes of nasal obstruction in adults. An anterior rhinoscopy (AR), which is usually the first diagnostic procedure in the evaluation of obstructive nasal pathologies, is often inadequate in the assessment of the posterior nasal cavity and the gold standard method for the evaluation of paranasal anatomy and inflammatory paranasal sinus pathologies is paranasal sinus computed tomography (PNS CT). Aim was to validate the recommendation of pre-operative computed tomography scan in minimizing post-septoplasty complications.

Methods: A retrospective record based study was conducted including all patients with clinically diagnosed DNS and undergone surgical intervention at Khamis Mushayet General Hospital. Data extracted included patients demographic data, and post-operative recorded complications and history of preoperative CT scan for evaluating and grading DNS.  

Results: A total sample of 60 patients’ undergone septoplasty for DNS. Patients who undergone preoperative CT were 30. The remaining 30 patients didn’t undergone pre-operative CT for evaluation of DNS. The most diagnosed complication was nasal obstruction (28.3%) followed by external nose deformity (20%). Exact of 47% of patients had postoperative nasal obstruction didn’t undergone pre-operative CT. About 42% of those who had postoperative nasal deformity didn’t undergone CT while 33% of patient who had post-operative bleeding and septal perforation didn’t undergone CT.

Conclusions: In conclusion, the study revealed that preoperative CT showed insignificant efficacy in relieving nasal obstruction or minimizing postoperative complications.

References

Bhattacharyya N. Ambulatory sinus and nasal surgery in the United States: demographics and perioperative outcomes. Laryngoscope. 2010;120(3):635-8.

Stewart MG, Smith TL, Weaver EM. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Neck Surg. 2004;130(3):283-90.

Chambers KJ, Horstkotte KA, Shanley K, Lindsay RW. Evaluation of improvement in nasal obstruction following nasal valve correction in patients with a history of failed septoplasty. JAMA Facial Plast Surg. 2015;17(5):347-50.

Mladina R, Čujić E, Šubarić M, Vuković K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29(2):75-82.

Bezerra TFP, Stewart MG, Fornazieri MA, et al. Quality of life assessment septoplasty in patients with nasal obstruction. Braz J Otorhinolaryngol. 2012;78(3):57-62.

Setzen G, Ferguson BJ, Han JK. Clinical consensus statement: appropriate use of computed tomography for paranasal sinus disease. Otolaryngol Neck Surg. 2012;147(5):808-16.

Kim DH, Park HY, Kim HS. Effect of septoplasty on inferior turbinate hypertrophy. Arch Otolaryngol Neck Surg. 2008;134(4):419-23.

Rowe SP, Lugo-Fagundo C, Ahn H, Fishman EK, Prescott JD. What the radiologist needs to know: the role of preoperative computed tomography in selection of operative approach for adrenalectomy and review of operative techniques. Abdom Radiol. 2019;44(1):140-53.

Lebowitz RA, Galli SKD, Holliday RA, Jacobs JB. Nasal septal deviation: a comparison of clinical and radiological evaluation. Oper Tech Otolaryngol Neck Surg. 2001;12(2):104-6.

Eyigör H, Küçüktepe Ü, Yılmaz MD. Is Performing the Paranasal Sinus CT Before the Septal Operation Change the Indication of Surgery? 2018.

Günbey E, Günbey HP, Uygun S, Karabulut H, Cingi C. Is preoperative paranasal sinus computed tomography necessary for every patient undergoing septoplasty? Int Forum Allerg Rhinol. Wiley Online Library. 2015;5:839-45.

Murrell GL. Components of the nasal examination. Aesthetic Surg J. 2013;33(1):38-42.

Branstetter BF, Weissman JL. Role of MR and CT in the paranasal sinuses. Otolaryngol Clin North Am. 2005;38(6):1279-99.

Karatas D, Yüksel F, Sentürk M, Dogan M. The contribution of computed tomography to nasal septoplasty. J Craniofac Surg. 2013;24(5):1549-51.

Ludwick JJ, Taber KH, Manolidis S, Sarna A, Hayman LA. A computed tomographic guide to endoscopic sinus surgery: axial and coronal views. J Comput Assist Tomogr. 2002;26(2):317-22.

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Published

2021-03-24

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Section

Original Research Articles