Is Performing the Paranasal Sinus CT Before the Septal Operation Change the Indication of Surgery?

Abstract

Objective: Septoplasty is the most common surgical procedure in patients with nasal obstruction caused by septum deviation. Anterior rhinoscopy and endoscopic nasal examination used to be the gold standard procedures performed to determine the septum deviation. However, many otolaryngologists nowadays perform a paranasal sinus computed tomography (CT) scan as a preoperative procedure for the evaluation of nasal anatomy and other sinonasal pathologies that may accompany it. The aim of this study was to evaluate whether a surgical procedure wasperformed in addition to septoplasty after a paranasal sinus CT in cases, in which septoplasty was decided during a routine otorhinolaryngology examination.Material and Methods: Patients who applied to the ENT outpatient clinic because of nasal congestion during the last year, were planned to have septoplasty after the nasal examination, and who accepted the operation were enrolled in the study. We investigated whether the planned surgical procedure changed after concomitant sinus pathologies were detected in CT.Results: A total of 378 patients, 113 female (29.9%) and 265 male (70.1%), were included in the study. A total of 247 patients (65.3%) had undergone only the septoplasty procedure, whereas 54 patients (14.3%) had septoplasty + inferior concha reduction, 44 (11.6%) patients had septoplasty + lateral middle concha resection due to concha bullosa, 33 (8.7%) had septoplasty + endoscopic sinus surgery due to chronic sinusitis, polyposis, or osteoma.Conclusion: We believe that sinonasal pathologies that cannot be determined a preoperative physical examination pre-operative CT is needed to detect any other deformities to correct by complimentary surgery added to septoplasty..