Indikace a funkční výsledkyseptoplastik– výsledky prospektivní studie

Indications and Functional Results of Septoplasty – Resultsof a Prospective Study

S u m m a r y:
Irregularity of nasal septum occurs in 80% of population, but not all of them re offunctional significance. The paper presents the results of a prospective study aimed at evaluationof correct indication for septoplasty,which should differentiate,whether nasal obstruction is causedby is caused by irregular nasal septum or mucosal changes in nasal cavity, to determine significanceof individual types of septum deformities in nasal obstruction with the use of rhinomanometrycompared with subjective evaluation and to measure functional effect of seroplasty. The groupincluded 63 examined patients (48men, 15women at the average age of 32 years),whowere indicatedfor septoplasty by common methods of examination (anterior rhinoscopy, case history). Fortypatients showed up for the measurement after the surgery. The objective examination of nasalpatency was tested by the rhinomanometric device ATHMOS 300. The mean value of nasal resistance(R) before the operation on the examined patients was 0.7 before the anamization and 0.4 afterthe anemization. This value is almost three-fold higher than normal values.However, normal valuesof nasal resistance R up to 0.25 were observed in 12 patients (20%). A subjective improvement ofnasal patency after the operation was reported by 36 patients (90%), remaining unchanged in theremaining four subjects. The resulting value of nasal resistance of the whole group after theoperation was 0.33 before anemization and 0.28 afterwards. It did not reach physiological values,but came close to them. The mean values of nasal resistance of the whole group improved by 55%.In the 40 surgically treated patients, normal values of R < 0.25 were established in 21 (52 %) only, allof them being satisfied with the outcome. In the other 19 (48%) patients, 15 subjected were satisfiedwith the results. However, objective improvement was reached in 52% of examined subjects only incontrast to 90% of patients being satisfied from subjective point of view. In the group of patientswhere objective improvement of R was established, there were no subjects considering the effect asinsufficient. This discrepancy was mostly due to patients with allergic rhinitis who experiencedsubjective improvement of nasal patency in spite of lasting rhinitis, although the objective valuesof nasal resistance did not changed significantly. The group with allergic rhinitis and a small septumdeformity represents a most controversial indication for septoplasty. The best improvement afterthe operation became obvious in patients with posttraumatic septum deformity who representedmost of the group. Rhinomanometric examination contributed to correct selection of patients for the operation especially in controversial cases, when clinical examination did not correlate withsubjective complaints of the patient.

Key words:
septoplasty, nasal septum, rhinomanometry, nasal resistance.