Histopathological effects of septoplasty techniques on nasal septum mucosa: an experimental study.

OBJECTIVE: The aim of this study is to evaluate the histopathological effects of septoplasty techniques on the nasal septal mucosa of rabbits with light and electron microscope. METHODS: The study was performed on 21 rabbits between August 2016 and February 2017. Rabbits were randomly divided into three groups. In Group-1, while preserving the L-strut structure of the septum, cartilage resection, was performed by open technique septoplasty. In Group-2, the same procedure was done except the resected cartilage was crushed and put back in place. No surgical procedure was performed on the Control group. Postoperative 2nd month; the specimens were histopathologically evaluated by light and electron microscope in terms of changes in the morphology of septum mucosa, perichondrial thickness, cilia and goblet cell deprivation, loss in glands, fibrosis and inflammatory cell infiltration in the lamina propria. RESULTS: The deprivation in cilia, goblet cells, serous gland and increase in the amount of collagen fibers were examined in both Group-1 and 2. The difference in Group-1 and Group-2 were statistically significant in terms of presence of cilia, number of goblet cells and glands and increase in collagen fibers when compared to control (p < 0.001, p = 0.002, p = 0.020, p = 0.002, respectively). In terms of perichondrium thickness, statistically significant difference was found between the Control and Group-2 (p < 0.001). CONCLUSiON: In this study, histopathological findings supported that the presence of cartilage in the septum is necessary to prevent the mucosal changes. Long-term studies are needed to observe whether changes in the morphology of epithelium and gland proceed more than 2 months follow-up.

Operation of lumbar zygoapophyseal joint cysts using a full-endoscopic interlaminar and transforaminal approach: prospective 2-year results of 74 patients.

In appropriate situations, extensive decompression with laminectomy often continues to be described as the method of choice for operations involving lumbar zygoapophyseal joint (z-joint) cysts. Tissue-sparing procedures are nevertheless becoming more common. Endoscopic techniques have become the standard procedures in many areas because of the advantages they offer in terms of surgical technique and in rehabilitation. One key aspect in spinal surgery was the development of instruments for sufficient bone resection carried out under continuous visual control. This enabled endoscopes to be used when operating on z-joint cysts. The objective of this prospective study was to examine the technical possibilities for the full-endoscopic interlaminar and transforaminal technique in lumbar z-joint cysts. A total of 74 patients were followed up for 2 years. The results show that 85% of the patients no longer have any leg pain or that the pain had been almost completely eliminated, and 11 % experience occasional pain. The complication rate was low. The full-endoscopic techniques brought advantages in the following areas: operation, complications, traumatization, and rehabilitation. The recorded results show that full-endoscopic resection of a z-joint cyst using an interlaminar and transforaminal approach provides an adequate and safe supplement, and is an alternative to conventional procedures when the indication criteria are fulfilled. It also offers the advantages of a minimally invasive intervention.