The authors have used the nasal endoscope for the precise identification of pathological abnormalities of the nasal septum in relation to the lateral nasal wall including the osteo-meatal complex and in its ultraconservative management. The aim of the study was to compare the efficacies of endoscope-aided septoplasty (EAS) over traditional septoplasty (TS) in treating the pathological septum and turbinates, performed in 30 cases each. The subjective assessment was carried out by visual analogue scores and objective assessment by nasal endoscopy. This study demonstrates the superiority and limitations of the endoscopic approach in managing a deviated nasal septum and the turbinates. The endoscope-aided technique was found to be more effective in relieving the contact areas and nasal obstruction (p = ≤0.05). The authors advocate a combined approach – an endoscopic approach for inaccessible posterior deviation and the conservative traditional technique for accessible anterior deviation of the nasal septum.

Day-stay surgery is an integral part of Otolaryngology. Many procedures which have traditionally been thought to require overnight stay can be carried out on a day care basis. We report our experience of treating 163 patients admitted for septal surgery as a day-case procedure. The paper summarizes the experience of two centres. One of these is a London Teaching Hospital, where surgery was performed through a dedicated day-case unit, and the other is a District General Hospital where patients were admitted to a day-case unit but had their surgery on a routine in-patient list.

As the result of this study we conclude that day-stay septoplasty is associated with a low complication rate and is a safe and acceptable procedure provided that strict selection criteria are followed. The cost implications are discussed.

Septal surgery (submucous resection and septoplasty) has been performed as a day-case procedure routinely under general anaesthesia and local anaesthesia with sedation at the Ipswich Hospitalsince 1992. The outcome of the day-case septal surgery over a period of 18 months has been audited. A total of 95 cases were operated on of which 48 were under general anaesthesia (GA) and 47 under local anaesthesia (LA) with sedation using midazolam intravenously. The bleeding rate and overnight admission rate were 10.5 and 11.4 percent respectively. The bleeding rate was the same in both GA and LA groups. The combination of local anaesthesia and sedation has been foundto be safe, effective and acceptable to patients. It is concluded that septal surgery is suitable as a day procedure and that local anaesthesia combined with sedation has a definite place ifcarried out properly.

The present study deals with the indication for inferior turbinate surgery in cases of concomitant anterior septal deviation. We define, by acoustic rhinometry, the characteristics of the obstructed nose and define mucosal turbinate hypertrophy. A random sample of 80 patients with nasal obstruction and anteriorly located septal deviation were objectively evaluated by acoustic rhinometry pre– and post–operatively. All had septoplasty and half were randomly selected to have anterior inferior turbinoplasty performed in the side opposite to the major septal deviation. Severe septal deviation, expressed by a minimal cross–sectional area less than 0.4 cm2 was present in 37 patients. In this group inferior turbinate reduction seems advisable. In the wide side, the minimal cross–sectional area and the cross–sectional areas at 3.3 and 4.0 cm from the nostrils increased in the turbinectomy group and decreased in the non–turbinectomy group after correction of the septal deviation. In the group with less pronounced septal deviation no influence of turbinate reduction could be detected.