Etiological analysis the cause of nasal obstruction after septoplast

Etiological analysis the cause of nasal obstruction after septoplasty" Nasal obstruction is a functional impairment which is frequent in population and impairs patients' quality of life. It may originate from mechanical causes related to anatomical disorders of bony and cartilagenous tissues forming nasal structures or dynamic causes from turbinates and mucosa that can congests and decongests. . It is a common cause of nasal obstruction and may be congenital or acquired in etiology. Septoplasty is one of the most commonly performed procedurein otorhinolaryngology practice. There is no improvement in the complaints of nasal obstruction in some of the patients after the septoplasty. The purpose of this study is to investigate the causes of subjective nasal obstruction in the postoperative period in patients with septoplasty surgery. This study was carried out between January 2016 and December 2016 at Atatürk Training and Research Hospital Otorhinolaryngology Clinic at least 6 months ago due to nasal obstruction and the nasal obstruction subjective evaluation methods nasal obstruction symptom evaluation scala NOSE) and Visual Analogue Scale (VAS) values were included in patients who supported the patient's complaint. Medical history were taken from all patients. All of them were examined (anterior rhinoscopy and nasal endoscopy) evaluated with NOSE, VAS, SFAR. All patients had CT scan. Causes of nasal obstruction with septoplasty were separeted into two groups; Group 1: causes associated with septoplasty and Group 2: causes not associated with septoplasty. Group 1 wasseparetedintotwogroups; Group1-a: inadequatesurgeryand group1-b:iatrogenic causes. In group 1-a; septum deviation, nasal valve stenosis, concha bullosa, inferior turbinate hypertrophy and gets collapse were divided into five subgroups. Group 1-b; nasal synechia, septal perforation, crusting, nasal tip ptosis and saddle nose (saddle nose) were divided into four sub-groups. If not for reasons connected with septoplasty surgery(group 2), allergic rhinitis, crusting connected to atrophic rhinitis, snoring and sleep apnea symptomatology, adenoid hypertrophy and nasal pathology undetected were divided into five subgroups, including patients.) We researched 124 patients in this study. 160(%85,4) patients had nasal obstruction symptoms because of the septoplasty related reasons, 42(%33,8) patients had nasal obstruction symptoms because of septoplasty unrelated reasons. It was found that 24(%19) patients had nasal obstruction symptoms because of both reasons. In Group 1, there were 96(%77,4) patients with inadequate surgery, 44(%35.4) patiens with iatrogenic reasons and 34(%24.1) patients with both reasons. ) As a result; In patients with septoplasty, it is important to consider the pathology causing postoperative nasal obstruction not only from the nasal septum but also in the presence of other etiologic factors, to perform adjunctive corrective operations in addition to septoplasty, to call the postoperative patient to regular controls, to prevent the postoperative complications, It is necessary to start medical treatment (anti-allergic) for additional pathology. Key words: Septoplasty, Nasal septum deviation, VAS, NOSE, Author's name: Özmen KARA Supervisor: Prof. Dr. A. Sami BERÇIN