Atlas of Nose and Paranasal Surgeries

ATLAS OF NOSE AND PARANASAL SURGERIES 1 Authors: M.M. Khan, S.R. Parab Title: Endoscopic Septoplasty—Two Handed Technique with Endoscope Holder: A Novel Approach Journal: Indian J Otolaryngol Head Neck Surg. DOI: 10.1007/s12070-016-0997-x © Association of Otolaryngologists of India 2016 Endoscopic Septoplasty—Two Handed Technique with Endoscope Holder Endoscopic septoplasty is a minimally invasive procedure allowing endoscopic guided removal of the deviated part of the nasal septum. a. Gross C shaped DNS, b. Gross S shaped DNS. (continued)... rhinitis and those in need of nasal surgery other than sep- toplasty for nasal obstruction were excluded from the study. The patients ranged from 19 to 49 years of age with a mean age of 27.28 ± 4.86 years. Preoperatively, the 1. Nose obstruction and stuffiness. 2. Nose obstruction. 3. Trouble breathing through my nose. 4. Trouble sleeping. 5. Unable to get enough air through my nose during exercise or exertion. Each of these were graded as 0: Not a problem. 1: Very mild problem. 2: Moderate problem. 3: Fairly bad problem. 4: Severe problem. Design and Concept of Khan’s Endoscope holder [ 7 ] (Patent Application No. 2313-Mum-2013) Khan’s Endoscope Holder is a metallic plate of 70 9 40 9 10 mm in dimensions with a slot measuring 16 9 16 mm in diameter mounted on the Otomicroscope stand (Optofine Microscope, India) after removal of the microscope head fastened with 4 screws. The arms and the control knobs of the Otomicroscope are utilised for imparting additional actions so that the endoscope holder can be rotated in any direction (forwards, backwards, Fig. 1 Gross C shaped DNS 123 the endoscope. We have been performing the two handed technique of endoscopic septoplasty with the help of Khan’s Endoscope Holder [ 7 ], which was primarily designed as an modification of the Otomicroscope, but the uses of it are being extended and extrapolated to incorpo- rate the Endoscope Holder into nasal surgeries. The con- cept, design and development of our Endoscope holder is published earlier [ 7 ]. The aim of this prospective non randomised clinical study is to report the preliminary use of our Endoscope Holder in two handed endoscopic septoplasty. Methods and Materials A total of 49 consecutive endoscopic septoplasties were operated with Khan’s Endoscope Holder from November 2014 to January 2015 in M.I.M.E.R Medical College and Sushrut ENT Hospital for patient with symptomatic septal deviations with a follow up period ranging from 6 to 8 months. A complete ENT examination was done in all patients. Inclusion criteria were above 18 years of age, symptomatic septal deviation consistent with nasal obstruction at least for 3 months inspite of medical man- agement (nasal steroid, antihistaminic and/or oral decon- gestants) (Figs. 1 , 2 ). The patients with sinusitis, allergic rhinitis and those in need of nasal surgery other than sep- toplasty for n sal obstruction were excluded from the study. The patients ranged from 19 to 49 years of age with a mean age of 27.28 ± 4.86 years. Preoperatively, the patients were asked to complete the Nose Obstruction Symptom Evaluation (NOSE) Questionnaire. Nose Scale for Evaluation of Nasal Obstruction [ 8 ] 1. Nose obstruction and stuffiness. 2. Nose obstruction. 3. Trouble breathing through my nose. 4. Trouble sleeping. 5. Unable to get enough air through my nose during exercise or exertion. Each of these were graded as 0: Not a problem. Fig. 2 Gross S shaped DNS 476 Indian J Otolaryngol Head Neck Surg (Oct–Dec 2016) 68(4):475–480 a b