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Submucous resection for deviated nasal septum: a critical appraisal
1ENT Department Hope Hospital, University of Manchester, School of Medicine, UK.
Abstract:
Submucous resection (SMR) for the deviated nasal septum had been criticised to have a higher complication rate and less patient satisfaction than septoplasty. Seventy-five patients who underwent SMR were studied and followed up at 6 months to 56 months post-operatively. The rates of short and long term complications were relatively low: septal haematoma 1.3%, nasal infection 1.3%, epistaxis 2.6%, external nasal deformity 9.3% and septal perforation 2.7%. While most patients achieved short term relief of nasal obstruction (93.4%), about 30% had persistent/recurrent nasal obstruction on long term follow-up. Similar rates had been quoted for the operation of septoplasty. We postulated that this was due to unfavourable airflow patterns as a result of minor residual septal deviation. Some patients had associated pre-operative symptoms of snoring (57.3%), headache (48.0%), rhinorrhoea (38.7%), sneezing (30.7%), hyposmia (30.7%) and epistaxis (21.3%). Frequencies of cure/improvement of these symptoms after SMR were 34.9%, 33.3%, 24.1%, 30.4%, 60.9% and 43.8% respectively. The overall post-operative long term (average 23.5 months) satisfaction rate was almost 70%. SMR, being relatively easy to perform, and having similar complication and patient satisfaction rates as septoplasty, should be retained in the surgical armamentarium for the deviated nasal septum.
Insights
Submucous resection (SMR) for deviated nasal septum shows low complication rates and nearly 70% long-term patient satisfaction. This surgical technique for nasal obstruction should remain a viable option.
Area of Science:
- Otolaryngology
- Surgical Outcomes
- Rhinology
Background:
- Submucous resection (SMR) for deviated nasal septum faces criticism regarding complication rates and patient satisfaction compared to septoplasty.
- Evaluating SMR's efficacy and safety is crucial for surgical decision-making in treating nasal septum deviation.
Purpose of the Study:
- To assess the complication rates, symptom relief, and long-term patient satisfaction following submucous resection (SMR) for deviated nasal septum.
- To compare the outcomes of SMR with reported outcomes of septoplasty.
Main Methods:
- A retrospective study of 75 patients who underwent SMR for deviated nasal septum.
- Post-operative follow-up ranged from 6 to 56 months, assessing complications and symptom resolution.
Main Results:
- Low complication rates observed: septal hematoma (1.3%), infection (1.3%), epistaxis (2.6%), external deformity (9.3%), and perforation (2.7%).
- Short-term relief of nasal obstruction was high (93.4%), but 30% experienced persistent/recurrent obstruction long-term.
- Significant improvement in associated symptoms like snoring (34.9%), headache (33.3%), rhinorrhea (24.1%), sneezing (30.4%), hyposmia (60.9%), and epistaxis (43.8%) was noted.
- Overall long-term patient satisfaction reached nearly 70%.
Conclusions:
- Submucous resection (SMR) demonstrates acceptable complication rates and patient satisfaction, comparable to septoplasty.
- Despite some long-term obstruction recurrence, SMR remains a valuable and relatively straightforward surgical option for deviated nasal septum.