Our Septoplasty Results: Evaluation with the Nose Scale.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of septoplasty and septoplasty + bilateral radio frequency ablation of inferior turbinate (b-RFAIT) according to the type of operation, age groups, gender of patients, and the duration of control period by using Nasal Obstruction Symptom Evaluation (NOSE) Scale. MATERIALS AND METHODS: Prospective observational study was undertaken in the otolaryngology department of a training hospital. Using the NOSE scale, the study prospectively compared the results of septoplasty only and septoplasty with b-RFAIT in the treatment of nasal obstruction caused by the combination of septal deviation and turbinate hypertrophy. Patients were divided into 2 groups. The first group had only septoplasty and the second group had septoplasty with b-RFAIT. General and local anesthesia were applied in both groups. To review clinical success, all patients were controlled at the 1st week, 1st month, and 3rd month. RESULTS: One hundred seventy-eight adult patients (male/female: 127/51) with chronic nasal obstruction complaint were enrolled in this prospective study. Our data demonstrated significant improvement from baseline after 24 months for the NOSE scores in both the septoplasty and septoplasty + b-RFAIT groups. No statistical difference was noted in the amount of postoperative improvement between the 2 treatment groups ( P = 0.306). No significant difference was observed between general and local anesthesia with respect to patients' preop and postop mean scores ( P > 0.05). There was a significant difference between the age of patients' postoperative mean ( P < 0.001). There were 4 postoperative means with respect to control time. There was an 82.29% decrease in the complaints of patients at 0 to 6 months, 80.51% decrease at 7 to 12 months, 76.1% decrease at 13 to 18 months, and 59.67% decrease at 19 to 24 months. Only the last group had a significant difference regarding mean change in scores ( P < 0.001). CONCLUSIONS: This study shows that septoplasty + bilateral turbinate radiofrequency should be applied to patients who suffer from septum deviation with concha hypertrophy. Postoperative NOSE scale shows that the success of operation does not depend on the gender of patients and operation types (general or local anesthesia). We conclude that younger patients (18-40 age) who have obstruction with septal deviation and septum deviation with concha hypertrophy benefit more from operation than older patients do.

Results of revision mastoidectomy.

CONCLUSIONS: Successful canal wall down (CWD) mastoidectomy requires removal of all diseased air cells, lowering of the facial ridge to the mastoid segment of the facial nerve, complete removal of the lateral epitympanic wall, and amputation of the mastoid tip. Additionally, the inferior canal wall should be lowered to adequately expose the hypotympanum, which allows a smooth transition into the mastoid cavity. An adequate meatoplasty is also necessary. Closed supratubal recess should be opened, anulus and tympanic membrane remnant should be removed in CWD cases. Revision mastoidectomy has a high success rate in obtaining a dry and epithelialized ear. OBJECTIVE: This study reports revision mastoidectomy results and indicates factors that must receive attention in chronic otitis media surgery to produce less revision surgery. PATIENTS AND METHODS: Thirty-five patients who underwent revision mastoidectomy with or without cholesteatoma between 2005 and 2008 were analyzed retrospectively. Patients who had revision mastoidectomy with previous intact canal wall (ICW) or CWD mastoidectomies were included in the study. RESULTS: Patients were aged 32-69 years (mean 57.4). There were 22 female and 13 male patients. Revision mastoidectomies were applied to 14 previous ICW and 21 prior CWD mastoidectomies. Of the 35 patients, 24 patients had cholesteatoma and 11 of them did not. Of the patients who had revision surgery, 10 had ICW mastoidectomy and 25 had CWD mastoidectomy. After revision mastoidectomy, at 3-25 months follow-up (mean 16.7 months), 29 patients had been successfully treated; they had dry well epithelialized cavity, with no findings of persistent, recurrent discharge or granulation tissue and cholesteatoma. In 21 patients in whom revision CWD mastoidectomy was performed, causes of failure of previous ear surgery in order of frequency were recurrent or persistent cholesteatoma and narrow meatoplasty (80.9%), persistent sinodural angle air cells and close supratubal recess (71.4%), high facial ridge and inadequate canalplasty (66.7%), persistent tegmental air cells and tympanic membrane remnant (57.1%), persistent mastoid apex air cells and open eustachian orifice (52.4%). Causes of failure after our revision ICW mastoidectomy in order of frequency were persistent or recurrent cholesteatoma (78.6%), closed supratubal recess (64.3%), persistent sinodural angle air cells, inadequate canalplasty and persistent mastoid apex air cells (57.1%), persistent tegmental air cells (42.9%).