Evaluation Of CO2 Laser In Nasal Septoplasty

SummaryNasal obstruction is a very common problem. The most common cause of nasal obstruction is nasal septum deformity.This study was planned to include patients with nasal septum deformity in the form of cartilaginous septal spur and anterior septal deviation.These patients were classified into two groups:1st group:35 patients had been operated by traditional septoplasty technique.2nd group:35 patients had been operated by CO2 laser septoplasty technique.Preoperatively, all patients were subjected to the following:1- Full history taking.2- Thorough clinical examination.3- Endoscopic examination.4- Acoustic rhinometry.5- Radiological examination of the nose and paranasal sinuses.Postoperatively, all patients were subjected to the followings:1- Clinical outcome.2- Endoscopic examination.3- Acoustic rhinometry.Surgical techniques:1- Traditional septoplasty:- Incision at the caudal end of the septal cartilage.- Mucoperichondrial and mucoperiosteal flaps are elevated on both sides.- Separation of the septal cartilage from humerus and perpendicular plate.- The cartilage is freed from the maxillary crest, then inferior striop of cartilage is removed if necessary.- Excision of any spur.- Suture the incision with 4/0 silk suture, then put Vaseline pack for 48 hours.2- CO2 laser septoplasty:Used a CO2 laser on superpulse continuous mode with power setting equal 10 W for ablation of septal spur and shaving the anterior moderate septal deviation from anterior to posterior with no more than 2 to 3 mm of vertical resection height to permit good mucosal healing and closure after operation. The mucoperichondrium of the controlateral side is left intact, and the continuity of bony cartilaginous vault is preserved, avoiding the risk of collapse and necrosis.There is no need for nasal pack postoperatively.