Efficacy of septoplasty with endoscopic osteomeatal clearance in the management of headaches due to chronic sinusitis secondary to Deviated nasal septum

Binu Babu, Anjana Mary Reynolds, Gopinathan Pillai N.


Background: Deviated nasal septum (DNS) is a common condition which affects most children and adults. Several surgical procedures are available for DNS. Endoscopic septoplasty is a minimally invasive surgical technique which can minimise trauma to the nasal septum and decrease post-operative morbidity. The present study was aimed to study the efficacy of septoplasty with endoscopic osteomeatal clearance, on headache due to sinusitis secondary to DNS.

Methods: The study was longitudinal in nature and involved patients undergoing septoplasty with endoscopic osteomeatal clearance at Government Medical College Hospital, Kottayam, Kerala, India. Patients with significant nasal obstruction due to DNS, and having recurrent sinusitis causing headache, were included into the study. Patients were discharged after 3 days and were called up for review at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year and evaluated for change in headache as assessed by visual analogue score (VAS). 

Results: A total of 50 participants were enrolled into the study over a period of 2 years. Maxillary sinus was involved in almost 96% of the cases while frontal sinus was affected in 46% and ethmoid sinus in 50% of participants. Seventy four percent participants had subjective symptomatic improvement at 2 weeks after surgery. The mean (SD) VAS score pre-operatively was 6.54 (1.5) and it improved to 4.18 (1.8) at 2 weeks following surgery (p <0.05).

Conclusions: Septoplasty with endoscopic osteomeatal clearance is a procedure which is highly efficacious and well tolerated in treating headache due to sinusitis secondary to DNS.


Nasal septum, Rhinoplasty, Endoscopy, Nasal obstruction

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Chintapatla S, Kudva YC, Nayar RC, Raghuveer TS, Prasad D. Septal deviation in neonates. Indian Pediatr. 1989;26(7):678-82.

Gray LP. Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Suppl. 1978;87(3):3-20.

Reitzen SD, Chung W, Shah AR. Nasal septal deviation in the pediatric and adult populations. Ear Nose Throat J. 2011;90(3):112-5.

Naeimi M, Garkaz M, Naeimi MR. Comparison of Sinonasal Symptoms in Patients with Nasal Septal Deviation and Patients with Chronic Rhinosinusitis. Iran J Otorhinolaryngol. 2013;25(70):11-6.

Abreu RR, Rocha RL, Lamounier JA, Guerra AF. Etiology, clinical manifestations and concurrent findings in mouth-breathing children. J Pediatr (Rio J). 2008;84(6):529-35.

Madani SA, Hashemi SA, Modanluo M. The incidence of nasal septal deviation and its relation with chronic rhinosinusitis in patients undergoing functional endoscopic sinus surgery. J Pak Med Assoc. 2015;65(6):612-4.

Aziz T, Biron VL, Ansari K, Flores-Mir C. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg. 2014;43(1):11.

Tzadik A, Gilbert SE, Sade J. Complications of submucous resections of the nasal septum. Arch Otorhinolaryngol. 1988;245(2):74-6.

Edwards N. Septoplasty. Rational surgery of the nasal septum. J Laryngol Otol. 1975;89(9):875-97.

Edwards N. Septoplasty. Rational surgery of the nasal septum. J Laryngol Otol.1975 Sep;89(9):875-97.

Ghazipour A, Abshirini H, Hekmat shoar M, Pursalehan S. Sinonasal Headaches and Post-Operative Outcomes after Septoplasty in Patients with Nasal Septal Deviation. Iran J Otorhinolaryngol. 2011;23(65):133-9.

Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-6.

Paradis J, Rotenberg BW. Open versus endoscopic septoplasty: a single-blinded, randomized, controlled trial. J Otolaryngol Head Neck Surg. 201;40(1):28-33.

Bothra R, Mathur NN. Comparative evaluation of conventional versus endoscopic septoplasty for limited septal deviation and spur. J Laryngol Otol. 2009;123(7):737-41.

Shrestha I, Pokharel M, Dhakal A, Amatya RC. Study to Compare and Evaluate Traditional vs. Endoscopic Septoplasty. Kathmandu Univ Med J. 2015;13(50):109-14.