Short- and mid-term results of limited approach septoplasty

Purpose: Limited approach septoplasty (LAS) follows the principle of respecting nasal structures and aims to minimize complications while ensuring proper nasal respiratory function. LAS is only applicable to selected cases of septal deviation. The present study aimed to: (1) compare short- and mid-term complications in two consecutive series of patients with the same type of septal deviation treated with LAS or classical septoplasty; and (2) examine postoperative respiratory function with active anterior rhinomanometry in the two series, and in a group of healthy, non-surgical volunteers. Methods: The study concerned two groups of 20 consecutive patients who underwent LAS or classical septoplasty for deviation in Cottle's areas 4/5, and a control group of 11 healthy adult volunteers with no sinonasal disorders. Results: The mean operating time did not differ significantly between the two groups. Three patients in each group developed minor complications. In a sitting position, the mean total nasal inspiratory resistance was 0.018 and 0.019 Pa ml/s (p = 0.46) in the LAS and classical septoplasty groups, respectively, and the total expiratory resistance was 0.019 and 0.018 Pa ml/s (p = 0.30). In a supine position, the mean total nasal inspiratory resistance was 0.017 and 0.021 Pa ml/s (p = 0.05), and the total expiratory resistance was 0.017 and 0.019 Pa ml/s (p = 0.14) in the LAS and classical septoplasty groups, respectively. Conclusion: In selected cases, LAS achieved much the same short- and mid-term results as classical septoplasty. The mini-invasive approach is certainly more respectful of the nasal mucosa, requiring a less extensive detachment, with consequent faster healing times and less tissue damage.