Cartilaginous Batten Graft Septoplasty in Caudal Septal Deviation

Study Overview
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Brief Summary
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To evaluate the clinical outcomes of septoplasty using cartilaginous batten graft in cases with caudal septal deviation as regards the relieve of nasal obstruction and aesthetic results.

Detailed Description
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A prospective study will be conducted over 15 patients indicated for septoplasty. Preoperative assessment: History NOSE (nasal obstruction septoplasty effectiveness score): Higher NOSE scores indicate worse nasal obstruction (range: 0-100). Visual analogue scale (VAS) (0-10) of nasal obstruction:For nasal obstruction Examination: Anterior rhinoscopy: to confirm caudal septal deviation. Endoscopic nasal examination: to exclude HIT, polyp, mass and discharge. Basal view photograph. CT nose and paranasal sinuses to exclude other pathology. Operative procedures: General anesthesia. Hemitransfixtion incision on the concave side The mucoperichondrial flap of the septum will be elevated A contralateral flap will be elevated from the caudal aspect of the cartilage Subperichondrial dissection into the nasal floor The curved portion of the septal cartilage will be harvested by excision, leaving an L-strut of dorsal and caudal cartilaginous septum A caudal septal batten graft created from harvested septal cartilage, then will be sutured using three or four stitches (5-0 polydioxanone sutures). If C-shaped caudal deviation without angulation or dislocation, cartilaginous batten graft fixed on the concave side If there is angulation of caudal septal end, the caudal strut will be cut by scissors at the most convex point in the caudocephalic direction. Excessive lower and upper caudal struts will be overlapped and sutured together with batten graft If dislocated, the septal cartilage will be separated from the anterior nasal spine (ANS) and maxillary crest for reposition. If there is an excessive cartilage portion, it will be removed and then the graft will be sutured The hemitransfixion incision will be closed using 5-0 Vicryl Internal nasal splint and anterior nasal pack will be placed in both sides

Official Title
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Clinical Outcomes After Septoplasty Using Cartilaginous Batten Graft in The Management of The Caudal Septal Deviation

Conditions
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Nasal Septal Deviation

Intervention / Treatment
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* Procedure: cartilaginous batten graft septoplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Patient presented with nasal obstruction or disfigurement due to anterocaudal septal deviation. Exclusion Criteria: Previous septal surgery Deformed nose, which necessitate external rhinoplasty approach. Other endonasal cause of nasal obstruction other than deviated nasal septum Bleeding disorder or systemic diseases. Patient who will not complete the follow up periods.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Septoplasty Using Cartilaginous Batten Graft<br>septoplasty using cartilaginous batten graft in cases with caudal septal deviation | Procedure: cartilaginous batten graft septoplasty<br>* septoplasty using cartilaginous batten graft in cases with caudal septal deviation<br>* Other names: batten graft septoplasty;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nasal obstruction | We will use the validated Nasal obstruction septoplasty effectiveness score: (range: 0-100) Higher NOSE scores indicate worse nasal obstruction. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Aesthetic results | Basal view photography: Two independent observers will review the photographs and 4-point grading system will be used to evaluate results: Grade I: Will indicate that the patient has little or no photographic evidence of residual caudal septal deviation. Grade II: The caudal septal deviation show marked improvement but still detectable by careful observation. Grade III: The caudal deviation is only mildly improved or not improved from the preoperative assessment. Grade IV: The caudal deviation is worse after surgical intervention | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Caudal septal deviation, Batten graft, Septoplasty