| Background:Nasal septum deviation(NSD)refers to the deviation of the nasal septum to one or both sides,or local protrusion,resulting in nasal dysfunction such as nasal congestion,epistaxis and headache.The clinical application of corrective surgery for nasal septum deviation has been going on for a long time,and the surgical methods are still being improved constantly,especially since the development of nasal endoscopic surgery,surgical innovations have been reported.At present,personalized deviated nasal septum plasty is becoming the first choice for correction of deviated nasal septum.Objective:This study was conducted to compare the clinical efficacy of two types of fragment septoplasty for the treatment of patients with deviated nasal septum,to evaluate the effectiveness and safety of the two surgical methods,to clarify the advantages and disadvantages of the two procedures,and to select a more suitable and beneficial surgical method for patients in the clinical work.MethodsA retrospective study was conducted to analyze the clinical data of 80 patients with deviated nasal septum who attended our hospital between January 2018 and June 2021,and the patients were divided into two groups: group A: 40 cases of fragment septoplasty and group B: 40 cases of modified fragment septoplasty.Group B reduced the difficulty of fragment septoplasty,optimized the procedure and reduced the cost by performing central cross strip excision of septum cartilage and reducing the use of abrasive drilling of septum bone.Baseline data,type of nasal septal deviation,total operating time(min),septoplasty operating time(min),intraoperative bleeding(ml),intraoperative and postoperative complications,and total hospitalization days(days)were statistically analyzed in both groups.Patients were discharged from the hospital with regular outpatient follow-up or telephone follow-up for six months.Imaging data such as nasal endoscopy and CT were collected during the patients’ follow-up,and the patients’ endoscopic nasal septal deviation scores and visual analogue scale(VAS)of nasal congestion were compiled and analyzed one day before and six months after surgery.Endoscopic septal deviation scores and visual analogue scale(VAS)of nasal congestion were collected from patients one day before surgery and six months after surgery,respectively.Classified variables are expressed in terms of frequency and percentage,using chi-square test,continuous variables in accordance with normal distribution are expressed as mean ±standard deviation,and t-tests are used for comparison between groups.Continuous variables that did not conform to a normal distribution were expressed as medians(first quartile,third quartile).Data comparison between the two groups,including VAS scores 1 day before surgery versus 6 months after surgery,nasal endoscopic septal deviation scores and time to surgery was performed using a nonparametric test(Mann-Whitney U test)for two independent samples.Within the same group,preoperative and six-month postoperative VAS scores,nasal endoscopic septal deviation scores were compared using a nonparametric test(Wilcoxon signed rank test)for two paired samples,and a statistically significant difference could be indicated when the two-sided test level P<0.05.RESULTSThe surgery was completed successfully in both groups with mild postoperative reactions,and no serious intraoperative bleeding or significant postoperative complications occurred in either group.1)The mean age of patients in group A was 35.0 years,33 male patients and 7 female patients;the mean age of patients in group B was 35.7 years,29 male patients and11 female patients,and there was no significant difference between the baseline data of the two groups by chi-square test(P>0.05).Patients with nasal septal deviation in group A included 18 with C-shaped deviation,8 with S-shaped deviation,7 with Spinous process and 7 with crest;patients with nasal septal deviation in group B included 12 with C-shaped deviation,13 with S-shaped deviation,8 with Spinous process and 7 with crest,and there was no significant difference between the two groups(P value 0.483>0.05 by chi-square test).2)VAS scores in group A improved from 7(6,8)preoperatively to 3(2,4)postoperatively;VAS scores in group B improved from 8(7,9)preoperatively to 3(2,5)postoperatively,and VAS improved in different septal deviation types within both groups compared with preoperatively,and the difference was statistically significant(P<0.05),and there was no significant difference between preoperative and postoperative VAS scores between the two groups(P>0.05).3)The postoperative nasal endoscopic septal deviation scores in groups A and B were significantly lower than those before surgery,and the difference was statistically significant(P > 0.05),and there was no significant difference between the preoperative and postoperative nasal endoscopic scores between the two groups(P< 0.05).4)There was no statistical difference in intraoperative bleeding(ml)and hospitalization days(days)between the two groups A and B(p-value 0.085,0.118 >0.05,respectively);5)The total operative time of 105(89.3,120)min and septal operative time of 20(18,26)min in group B were shorter than the total operative time of 135(117.5,148.8)min and septal operative time of 30(26.3,37)min in group A,and the difference was statistically significant(P<0.05)Conclusion:1.The VAS scores and nasal endoscopic deviation scores of patients in both groups were significantly reduced six months after surgery compared with those before surgery,and the differences were statistically significant,and no postoperative complications were seen in the nasal endoscopic review of patients in both groups,indicating that the fragment method septoplasty in group A and the modified fragment method septoplasty in group B have the clinical efficacy of improving nasal congestion symptoms and correcting patients’ septal deviation morphology for patients with different types of nasal septal deviation.The clinical efficacy of both procedures is safe and effective.2.In terms of intraoperative bleeding and hospital days,the modified fragment method of septoplasty did not increase the risk of intraoperative bleeding or prolong the number of days patients were hospitalized.3.The modified fragmentary septoplasty optimizes the surgical steps,saves costs,and further reduces the required operative time while achieving the same clinical outcome.For patients with deviated septum,the modified fragmentary septoplasty is more advantageous. |
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