Impact of nasal septum deviation types on intraoperative mucoperichondrial perforation during septoplasty: A prospective cohort study
Science Progress, cilt.108, sa.4, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 108 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.1177/00368504251411215
- Dergi Adı: Science Progress
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, INSPEC, Directory of Open Access Journals
- Anahtar Kelimeler: Septoplasty, nasal septum deviation, Mladina classification, septal perforation, intraoperative complications
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To evaluate whether nasal septum deviation type is associated with intraoperative mucoperichondrial perforation during septoplasty. Methods: In this prospective observational cohort at Bağcılar Training and Research Hospital (Istanbul, Türkiye), 133 adults undergoing septoplasty for nasal obstruction were classified by the Mladina system. The primary outcome was the occurrence of mucoperichondrial perforation during surgery; secondary outcomes were laterality and the largest tear dimension. Group differences across deviation types were analyzed with appropriate comparative statistics; two-sided P < 0.05 was considered significant. Results: Perforation occurred in 63 of 133 patients (47.4%). Most tears were unilateral (98.4%); one patient (0.8%) had bilateral tears constituting a septal perforation. Perforation incidence differed by deviation type (P < 0.001): Type I, 5.9%; Type II, 31.3%; Type III, 37.8%; Type IV, 78.6%; Type V, 65.2%; Type VI, 60.0%; and Type VII, 83.3%. Mean tear size increased with deviation complexity, measuring ∼2–5 mm in Types I–III versus 6–8 mm in Types IV–VII (P < 0.05). Perforation frequency and size did not differ between surgeons. Conclusion: Nasal septum deviation morphology is strongly associated with the risk and extent of mucoperichondrial perforation during septoplasty. Patients with complex deviation patterns (Types IV–VII) have a substantially higher risk; recognizing these patterns preoperatively may inform counseling and encourage meticulous dissection strategies to reduce mucosal injury and the likelihood of septal perforation.