Wednesday, February 20, 2019

Rhinoplasty Vs Septoplasty. What’s The Difference?

Rhinoplasty Vs Septoplasty

Septoplasty is the surgical technique that aims to correct deformities of the nasal septum. The deviation of the nasal septum is the main cause of nasal obstruction, which is the most common symptom and the main reason for consultation for Rhinoplasty in Michigan. It is important to highlight that deviation of the nasal septum also cause epistaxis, sinusitis, obstructive sleep apnea syndrome (OSAS), and headache, due to the friction of the nasal septum with structures of the lateral wall of the nasal cavity.

A complete medical evaluation must be carried out before considering the surgical treatment of septum deviation by means of septoplasty; therefore, the evaluation of the patient’s wishes should be included, mainly in relation to the performance of rhinoplasty, and to know precisely the anatomical alterations and functional nasal, through tests such as anterior rhinoscopy, nasal endoscopy, acoustic rhinometry, rhinomanometry and computed tomography of paranasal cavities.

Indications of septoplasty

  • Symptomatic nasal obstruction.
  • Deformity of the nose.
  • Access improvement in nasosinusal endoscopic surgery.
  • Access improvement in skull base surgery.
  • Correction of anatomical alterations that predispose to chronic or recurrent sinusitis.
  • Headache relief by contact points.

Conventional septoplasty

Conventional septoplastyThe term septoplasty may involve a simple operation to mark the septum, remove a part of the septum, or perform a septal submucosal resection to be used in rhinoplasty Michigan.

Conventional septoplasty is a procedure performed by direct visualization of the nasal cavity using frontal light and nasal speculum, so that field vision is limited, especially in the visualization of the lower and posterior third of the septum. On certain occasions, it is difficult to determine the relationship between the septum and lateral nasal wall, and also hinders the complete evaluation of the posterior septum. One of its main advantages is that it requires simple instrumentation, and it is also a quick procedure when performed by experienced surgeons.

Endoscopic Septoplasty

The initial objective of endoscopic septoplasty is to repair punctual septal deformities that cause nasal obstruction and make it difficult to approach the nasal sinuses during Nasosinusal Endoscopic Surgery (NES).

There are several advantages of this technique over the conventional procedure, highlighting the best visualization of the field, since it allows greater magnification, illumination, and exposure of the nasal cavity, facilitating the optimal recognition of the tissues. In addition, better vision during the procedure minimizes lacerations in the mucosa and decreases the risk of perforation.

Endoscopic septoplasty allows the punctual approach of localized septal deviations, septal spurs, perforations, and contact sites, which allows for a more conservative procedure.

Clinical results

While the results are usually stable, the cartilage and tissue can move or change gradually over time. Nasal tissues remain relatively stable between three and six months after surgery. However, some changes may still occur up to a year or more after surgery.

The clinical results of endoscopic septoplasty are comparable to those of the conventional technique, showing significant resolution of nasal obstruction in 70% -80% of patients.

Some comparative studies with the conventional technique have found that endoscopic septoplasty is more effective in treating symptoms such as contact point headache. Regarding the symptoms in the postoperative period, there is a lower rate of pain, headache, facial edema and lacrimation using the endoscopic technique. Regarding the hospital stay, there are no significant differences between the conventional and endoscopic techniques.

Complications of septoplasty

The complications of septoplasty are infrequent, and mild. The general rate of complications is approximately 2% to 5%. The most frequent complications are listed below

  • Septal drilling (0.9% -3.4%)
  • Septal hematoma (0.9%)
  • Transient dental pain and hyperesthesia (4.3%)
  • Adhesions (2.6% -4.5%)
  • Nasal bleeding (0.9%)
  • Persistent Septo-deviation (0.9%)

More serious complications have been described in conventional septoplasty, among which the cerebrospinal fluid fistula, cavernous sinus thrombosis, meningitis, subarachnoid hemorrhage, cerebral abscess, periorbital emphysema, and blindness. The main factor to prevent complications is to achieve optimal visualization, in which endoscopic septoplasty has obvious advantages.

Professional recommendations

Avoid smoking in the weeks before and after surgery, as the toxins present in cigarettes alter the healing process and increase the risk of complications.

Avoid taking medications that contain acetylsalicylic acid for two weeks before and after surgery, as these alter blood clotting and predispose to bleeding. Take only medications approved or prescribed by the surgeon.

To further decrease the chances of bleeding and swelling, your top Michigan rhinoplasty surgeon will ask you to follow these precautions for several weeks after the surgery:

  • Avoid demanding activities such as aerobics and jogging because these activities can increase blood pressure and cause nosebleeds.
  • Do not blow your nose.
  • Lift your head when you are sleeping.
  • Wears clothing that closes and opens at the front; Do not wear clothes that are worn over the head, such as t-shirts or sweaters.

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source https://umassmedicalschool.com/2019/02/20/rhinoplasty-vs-septoplasty-whats-the-difference/

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