Role of hydrodissection in septoplasty: a modern outlook

Abstract

Abstract BACKGROUND. Septoplasty is an age-old surgery performed mainly for a deviated nasal septum. Various methods have been described and the surgery is left to the choice of the surgeon. Traditional septoplasty has taken a back seat in the modern era because of various complications. Newer techniques are being practiced owing to better outcomes. Hydrodissection for septal flap elevation has been both criticized and appreciated because of multiple reasons. In this study, we have used this technique in practice and evaluated its outcome. MATERIAL AND METHODS. 184 patients with Deviated Nasal Septum (DNS) were evaluated. 82 in Group 1 underwent conventional septoplasty with Freer’s elevator and 102 in Group 2 underwent septoplasty with hydrodissection using Normal Saline (NS). Time taken to perform flap elevation, status of the mucoperichondrial flap intra-operatively and scoring of adhesions 4 weeks postoperatively were the parameters of study. RESULTS. 19 out of 82 cases had tears in the mucoperichondrium in Group 1, amounting to 23.17%. 11 patients out of 102 had tears in Group 2, amounting to 10.78%. The average time taken to perform the flap elevation was 11 minutes in Group 1 and 5 minutes in Group 2. Average score in crusting/adhesions was 0.66 in Group 1 and 0.53 in Group 2, out of a possible 4. CONCLUSION. Hydrodissection in septoplasty for the elevation of the mucoperichondrium and mucoperiosteum is a useful step in surgery provided that it is performed using Normal Saline. It is easy to perform, inexpensive and completely safe to perform without any serious complications.