A Comparative Study of Correction of Caudal Septal Deviations

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3972-3977. doi: 10.1007/s12070-024-04757-x. Epub 2024 Jun 6.

Abstract

Background: There are multiple surgical approaches for the correction of caudal septal deviation.

Objectives: To compare the surgical outcomes of the widely used techniques of correction of caudal septal deviation.

Materials and methods: In a prospective study done over a period of 3 years, 36 patients with caudal septal deviation were selected and randomly divided into 3 groups of 12 each who underwent surgery by the following techniques: Group A - Swinging Door technique. Group B- Tongue-in-groove technique. Group C- The cutting and suture technique with unilateral bony batten grafting. The preoperative and postoperative (at 6 months) NOSE score, anterior rhinoscopy and subjective assessment were used to measure surgical outcomes and the techniques were compared.

Results: Out of the 36 patients, the mean NOSE score preoperatively and postoperatively were as follows. For Group A- 72.5 and 23.33. For Group B- 73.75 and 19.17. For Group C- 72 and 22. A significant improvement of mean 49.17, 54.58 and 50.00 with p-value of < 0.05 respectively. Anterior rhinoscopy done at 6 months postoperatively showed that 30 patients (83%) had a straight septum while 6 patients (17%) had some residual deviation. Subjective patient satisfaction was "much improved" in 17 (47.2%) patients, and "improved" in 19 (52.8%) patients. Four patients had postoperative synechia which were managed conservatively.

Conclusion: Surgical correction of caudal septal deviation resulted in significant improvements in nasal airway. The tongue-in -groove technique was found to be the most effective among the three.

Keywords: Batten graft technique; Caudal septal deviation; NOSE score; Swinging door technique; Tongue-in-groove technique.