J Rhinol.  2017 Nov;24(2):74-80. 10.18787/jr.2017.24.2.74.

Postoperative Septal Abscesses According to the Techniques of the Septoplasty

• Choi SY
• Lee HY
• Chang DS
• Choi MS

• KMID: 2398824
• DOI: http://doi.org/10.18787/jr.2017.24.2.74

Abstract

BACKGROUND AND OBJECTIVES
Recently, the swinging door and grafting techniques have been heavily used for straightening and holding the caudal septum. However, reconstructive septoplasties require more extensive dissection of septal structures. Extensive anatomical dissection and complicated procedures may affect the probability of postoperative bleeding and infection. MATERIALS AND METHOD: We retrospectively reviewed the records of 141 consecutive patients who underwent septal surgeries from February 2013 to December 2015. The patients were classified into two groups according to surgical technique: those who underwent submucous resection with or without endoscopy were classified as the "resection" group, while those who underwent the swinging door or batten graft technique were classified as the "reconstruction" group. The resection and reconstruction groups were matched using the propensity score. The incidence of postoperative septal abscesses (PSAs) was analyzed between the two groups.
RESULTS
For the two groups, 36 patients were matched with 36 patients (1:1) using the propensity score. Of the 72 patients, PSAs developed in 5 patients (6.9%). One patient was in the resection group (2.8%), while the other four patients were in the reconstruction group (11.1%). However, the incidence of PSAs was not significantly higher in the reconstruction group according to Fisher's exact test (p=0.164).
CONCLUSION
Reconstructive septoplasty resulted in more septal abscesses than resection, but the difference was not significant.

Keyword

Nasal septum; Postoperative complications; Septal abscess; Wound infection

MeSH Terms

Abscess*
Endoscopy
Hemorrhage
Humans
Incidence
Methods
Nasal Septum
Postoperative Complications
Propensity Score
Retrospective Studies
Transplants
Wound Infection

Figure

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  Fig. 1 Different techniques to correct deviated nasal septum. Classic submucous resection (top left). Endoscopic septoplasty (top right). Caudal batten graft (bottom left). Swinging door technique (bottom right).

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  Fig. 2 Comparison of postoperative septal abscesses rates between resection and reconstructive groups matched by the Propensity score.

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  Fig. 3 Granulation tissue that bled easily was seen on the mucosa of the septum by the right side. Purulent discharge was drained when incised around the granulation tissue on the septum.

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