Comparison of Outcomes of Conventional Septoplasty vs Conservative Endoscopic Septoplasty

Summary

OBJECTIVE To compare the outcome of conventional septoplasty and conservative endoscopic septoplasty for symptomatic deviated nasal septum.

DATA COLLECTION PROCEDURE This randomized control study will be conducted in the ENT department at Shaikh Zayed Hospital, Lahore, over six months. Ethical approval will be obtained and informed consent forms will be completed by all participants. A sample of 210 cases will be selected using a non-probability consecutive sampling technique, with patients randomized into two groups based on the lottery method: 105 will undergo conventional septoplasty (Group A), and 105 will undergo conservative endoscopic septoplasty (Group B). Detailed patient history and clinical examination will be recorded, and each case will be evaluated subjectively and objectively preoperatively. Nasal septal deviation will be classified based on the side (right, left, or S-shaped) and anatomical involvement (anterior, posterior, or both), with posterior rhinoscopy and diagnostic nasal endoscopy will be performed as needed to rule out other pathologies. For patients in the conventional septoplasty group, the traditional surgical technique for septoplasty will be applied in which bilateral flap elevation will be done. In the conservative endoscopic septoplasty group, an incision will be made 2 mm posterior to the caudal end of the septum (hemitransfixation) on the concave side to access the bony-cartilaginous junction abnormality. The initial mucoperichondrial flap will be elevated. Proper plane elevation will be performed to minimize bleeding, and exposure will be limited to the targeted area.

Conditions

• Deviated Nasal Septum

Interventions

PROCEDURE

conventional septoplasty

For patients in the conventional septoplasty group, the traditional surgical technique for septoplasty will be applied in which bilateral flap elevation will be done. In the conservative endoscopic septoplasty group, an incision will be made 2 mm posterior to the caudal end of the septum (hemitransfixation) on the concave side to access the bony-cartilaginous junction abnormality. The initial mucoperichondrial flap will be elevated. Proper plane elevation will be performed to minimize bleeding, and exposure will be limited to the targeted area. For cases involving subluxated cartilage from the crest, excess cartilage will be carefully trimmed with a No.15 blade Bard-Parker knife without disrupting the vomerochondral junction. Cartilage near the anterior nasal spine will be repositioned over the crest to prevent supra-tip deformity. Any laterally projecting vomerine spur or overlapping cartilage will be resected. In instances of posterior deviation or ethmochondral junction deviation, t

PROCEDURE

endoscopic septoplasty

In the conservative endoscopic septoplasty group, an incision will be made 2 mm posterior to the caudal end of the septum (hemitransfixation) on the concave side to access the bony-cartilaginous junction abnormality. The initial mucoperichondrial flap will be elevated. Proper plane elevation will be performed to minimize bleeding, and exposure will be limited to the targeted area. For cases involving subluxated cartilage from the crest, excess cartilage will be carefully trimmed with a No.15 blade Bard-Parker knife without disrupting the vomerochondral junction. Cartilage near the anterior nasal spine will be repositioned over the crest to prevent supra-tip deformity. Any laterally projecting vomerine spur or overlapping cartilage will be resected. In instances of posterior deviation or ethmochondral junction deviation, the bony septum will be fractured for midline alignment or minimally resected at the ethmoidal plate's caudal end. A 'C' shaped deviation will be corrected through prec

Sponsors & Collaborators

• Shahida Islam Medical Complex

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

16 Years

Max Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-11-18

Primary Completion

2026-01-17

Completion

2026-01-17

Countries

• Pakistan

Study Locations