Our Summary

This research paper talks about a surgical procedure called endoscopic endonasal dacryocystorhinostomy (EN-DCR). This procedure is used to treat obstructions in the tear ducts. Sometimes, the success of this procedure may be affected by other issues in the nose, such as a deviated septum (when the wall separating the nostrils is not straight). These other issues can make the surgery more difficult and increase the risk of complications.

The researchers looked at the medical records of patients who underwent this procedure at a medical university in Saint Petersburg between 2014 and 2019. They found that out of 212 patients, 36 (15.5%) needed additional surgery to correct a deviated septum. This additional procedure, called endoscopic septoplasty, was necessary to provide better access to the tear duct area during the EN-DCR procedure.

The researchers concluded that performing endoscopic septoplasty at the same time as EN-DCR can improve surgical access and increase the chances of a successful outcome.

FAQs

  1. What is endoscopic endonasal dacryocystorhinostomy (EN-DCR)?
  2. How can a deviated septum affect the success of an EN-DCR procedure?
  3. What is endoscopic septoplasty and why might it be necessary during an EN-DCR procedure?

Doctor’s Tip

A doctor might advise a patient undergoing septoplasty to follow post-operative care instructions carefully, including keeping the nasal passages moist with saline spray, avoiding strenuous activities that could increase bleeding, and attending all follow-up appointments to ensure proper healing. It is also important to communicate any concerns or changes in symptoms to the doctor promptly.

Suitable For

Patients who are recommended septoplasty typically have a deviated septum that is causing symptoms such as difficulty breathing through the nose, frequent sinus infections, nasal congestion, or snoring. Septoplasty may also be recommended for patients who are undergoing other nasal surgeries, such as sinus surgery or nasal reconstruction, to ensure optimal surgical access and outcomes. In the case of the research paper mentioned above, patients undergoing endoscopic endonasal dacryocystorhinostomy (EN-DCR) may be recommended septoplasty if a deviated septum is making the procedure more difficult or increasing the risk of complications. Ultimately, the decision to undergo septoplasty will depend on the specific symptoms and needs of each individual patient.

Timeline

Before septoplasty:

  • Patient experiences symptoms such as nasal congestion, difficulty breathing through the nose, frequent nosebleeds, and recurrent sinus infections.
  • Patient undergoes a consultation with an ENT specialist who recommends septoplasty to correct the deviated septum.
  • Patient undergoes pre-operative tests and evaluations to ensure they are a suitable candidate for surgery.

During septoplasty:

  • Patient is placed under general anesthesia.
  • Surgeon makes an incision inside the nose and repositions or removes the deviated portion of the septum.
  • Surgery typically takes about 1-2 hours.

After septoplasty:

  • Patient may experience pain, swelling, and nasal congestion for a few days following surgery.
  • Patient is prescribed pain medications and nasal sprays to help with recovery.
  • Patient is advised to avoid strenuous activities and to follow post-operative care instructions provided by the surgeon.
  • Patient attends follow-up appointments to monitor healing and address any concerns.

Overall, the goal of septoplasty is to improve nasal airflow, alleviate symptoms related to a deviated septum, and enhance the overall quality of life for the patient.

What to Ask Your Doctor

  1. What is a deviated septum and how does it affect the success of the EN-DCR procedure?
  2. Will I need to undergo endoscopic septoplasty in addition to the EN-DCR procedure?
  3. What are the potential risks and complications associated with endoscopic septoplasty?
  4. How will performing endoscopic septoplasty at the same time as EN-DCR improve the outcome of the surgery?
  5. What is the recovery process like for both procedures performed together?
  6. Are there any alternative treatment options for a deviated septum that may be considered instead of endoscopic septoplasty?
  7. How experienced are you in performing endoscopic septoplasty and EN-DCR procedures?
  8. What are the success rates of these procedures in improving symptoms related to tear duct obstructions and deviated septums?
  9. How long will it take for me to see results from both procedures?
  10. Are there any long-term effects or considerations I should be aware of after undergoing both procedures?

Reference

Authors: Karpishchenko SA, Vereshchagina OE, Karpov AA. Journal: Vestn Otorinolaringol. 2020;85(6):56-59. doi: 10.17116/otorino20208506156. PMID: 33474919