ABSTRACT
The most common cause of nasal obstruction is a deviated nasal septum. It causes breathing difficulties and may eventually also cause sinusitis, epistaxis, sleep disturbances and snoring. The traditional surgeries of the nasal septum improve the nasal airway but do not fulfil the essential criteria in most instances. Endoscopic septoplasty is a fast-developing concept and gaining popularity as it provides a direct targeted approach to the septal anatomic deformity allowing a minimally invasive procedure under excellent visualization. The aim of this study is to compare the post-operative morbidity among conventional and endoscopic septoplasty. The present prospective study was conducted on 50 patients having deviated nasal septum. Patients were randomly divided into two groups of 25 each. Out of 50 patients, in 25 patients (Group A) Conventional septoplasty was done, whereas in other 25 patients (Group B) endoscopic septoplasty was done. The patients were followed up post-operatively at 2 weeks, 4 weeks and 8 weeks. Study Design: comparative study. The mean of operating time (min) in Group A was 60.47 ± 8.16 which was significantly higher as compared to Group B (39.7 ± 6.73). (p value < .0001). The Mean of blood loss (mL) was significantly higher in Group A (88.67 ± 8.77) as compared to Group B. (54.6 ± 7.18). (p value < .0001). Post-operative NOSE score at one month was 7.33 ± 1.5 in group A which was significantly higher as compared to Group B (5 ± 1.41). (p value = 0.0007) whereas post-operative NOSE score at 3 months in Group A was 6.53 ± 1.25 which was significantly higher as compared to Group B (4.4 ± 1.78). Proportion of post-operative complications was comparable in Group A and Group B (No complication 80% vs. 92% respectively). According to the present study, both the conventional and endoscopic septoplasty procedures were effective in relieving nasal obstruction in the patients. Endoscopic septoplasty showed significantly better result than conventional septoplasty in terms of time taken for surgery, blood loss during the surgery, post-operative complications and in terms of quality of life as assessed by NOSE Score.
ABSTRACT
For a chronically discharging ear open mastoidectomy is the mainstay of treatment, however it can cause high morbidity due a large cavity and complications like discharge, vertigo and difficulty with hearing aids. To avoid such problem, obliteration of mastoid cavity is done. The objective of our study was to compare the post-operative complains, the hearing results and outcomes of open and closed mastoid cavity. The present prospective study was conducted on 40 patients having attico-antral disease in middle ear cleft. Patients were randomly divided into two groups of 20 each. Out of 40 patients, in 20 patients (Group A) mastoid obliteration was done using conchal cartilage, whereas in other 20 patients (Group B) canal wall down mastoidectomy without mastoid obliteration was done i.e.an open cavity. The patients were followed up post-operatively at 6th week, 3rd month and 6th month. Study Design: comparative study. On Pure Tone Audiometry, 13 (65%) patients with closed mastoid cavity had Air-bone Gap < 30 dB, 7 (35%) were in the range 30-60 dB as compared to open mastoid cavity where 10 (20%), 8 (40%), 2(10%) patients had ABG < 30db, 30-60 dB, and > 60 dB respectively, showing better hearing results in obliterated cavities, healing was also better. In obliterated mastoid cavities, there were very few complications of pain, discharge, and giddiness compared to open cavities. Healing as shown by epithelisation was earlier and better in obliterated cavities. Hearing results were better in mastoid cavities with obliteration compared to open cavities. Patients with obliterated mastoid cavity need less cavity care and doctor dependence.