Septoplasti sonrası nazal septal perforasyonlardaki risk faktörleri

Öz

Amaç: Septoplastinin sonrası uzun dönemde en sık görülen komplikasyon nazal septal perforasyonudur. Nazal septal perforasyon her iki nazal kavite arasındaki duvarın kısmen açılmasıdır. Bu çalışmamızda septoplasti sonrası ortaya çıkan septal perforasyonun nedenlerini inceleyeceğiz.

Yöntemler: Çalışma için 2016-2019 yılları arasında Kulak Burun Boğaz kliniğinde septoplasti operasyonu olan 18-50 yaş arası 400 hasta incelendi. Çalışma retrospektif-kohort olarak yapıldı. Bu hastalar perforasyonu olan ve olmayan iki gruba ayrıldı. Perforasyonu olan hastaların sigara ve alkol kullanımı, cinsiyet ve septum stabilizasyonu için kullanılan teknik açısından incelendi.

Bulgular: Hastaların 280 i erkek ve 120 si kadındı. Hastaların 378inde cerrahi sonrası septal perforasyon yoktu. 22sinde cerrahi sonrası perforasyon mevcuttu. Perforasyon olan gruptaki hastalardan 19u erkek 3 ü bayandı. Bu hastaların 21’i sigara içerken, 1 hasta içmiyordu. Bu hastaların 11 i alkol alırken 10 u alkol almıyordu. Perfore olan hastalarda septumu stabilize etmek için 14 hastada transseptal suturasyon + nazal doyle splint kullanılırken 8 hastada sadece nazal doyle splint kullanıldı. Yapılan cerrahi sonrası perforasyon oranı 22/400 (%1,3) idi. Perfore olan hastalarda erkek cinsiyet oranı anlamlı derecede baskındı (19/3) (P=0,022). Perfore olan gruptaki hastalarda sigara içen grup anlamlı derecede artmıştı (21/1) (P=0,012). Bu gruptaki hastalarda perforasyon oranı artışında, alkol alımı olanlarda anlamlı derecede farklılık izlenmedi (P=0,082). Septumu stabilize etmek için kullanılan yöntemler arasında anlamlı farklılık izlendi (P=0,023). Transseptal suturasyon yapılanlarda perforasyon oranı anlamlı derecede arttı (P=0,036).

Sonuç: Septoplasti sonrası perforasyonu olan hastalar incelendiğinde erkek cinsiyet, sigara kullanımı ve cerrahi teknik olarak transseptal suturasyonun perforasyon riskini artırdığı gözlendi.

Anahtar Kelimeler

• Nazal septal perforasyon,Septoplasti,Suturasyon,Sigara içmek

Risk factors for nasal septal perforation after septoplasty operation

Abstract

Aim: Nasal septal perforation is the most common complication in the long term after septoplasty. Nasal septal perforation is the partial opening of the wall between both nasal cavities. In this study, we will evaluate the causes of septal perforation after septoplasty.

Methods: 400 patients aged between 18 and 50 years who underwent septoplasty operation in Otorhinolaryngology clinic between 2016 and 2019 were evaluated. The study was performed as a retrospective cohort. These patients were divided into groups with and without perforation. Patients with perforation were evaluated in terms of age, gender, alcohol and cigarette use, and stabilization technique used in surgery.

Results: There were 280 male and 120 female patients in the study. 378 patients had no postoperative septal perforation. 22 had perforation after surgery. 19 of the patients in the perforated group were male and 3 were female. Male sex ratio was significantly dominant in perforated patients (19/3) (P=0.022). 21 of the patients were smoking and 1 patient was not drinking. (P=0.012). 11 of these patients were drinking alcohol and 10 of them did not drink alcohol. To stabilize the septum in patients with perforation while transseptal suturation + nasal splint was used in 14 patients, only nasal splint was used in 8 patients. The perforation rate after surgery was 22/400 (1.3%) (21/1) (P=0.012). There was no significant difference in the perforation rate among the patients with alcohol intake (P=0.082). There was significant difference between the methods used to stabilize the septum. The rate of perforation was significantly increased in patients who underwent transseptal suturation (P=0.023). 

Conclusion: Patients with perforation after septoplasty were found to increase the risk of perforation by male sex, smoking and surgical technique as transseptal suturing technique.

Keywords

• Nasal septal perforation,Septoplasty,Suturation,Smoking

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