septoplasty vs endoscopic septoplasty

[criticalelement]

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We put a young girl to sleep a few days ago for endoscopic septoplasty and father asks ME.. which is better endoscopic septoplasty vs reg septoplasty .. I said endoscopic septoplasty because the visualization is better.....

Any of you experienced with this.. Did I answer correctly? I looked it up and this is what I gather from the cursory lit search i performed.

 

[DrBodacious]

It is dealers choice. No way is inherently better.

In my hands, I like to use loupe magnification and a head light, most of the time. Endoscope help me out if there is a very posterior problem. Many people do not use loupe or endoscope magnification, and do a fantastic job. I like the loupe magnification mainly because I can avoid hunching over to look closely at times - I could see everything with out them, but the force me to use good posture. Endoscopes could potentially be more helpful in pediatric patients, due to smaller incisional apertures. I also use an endoscope for septoplsty sometimes when I am doing a concurrent FESS, just because I already have the endoscope out, and so therefore I don't have to wear a head light.

 

[OtoHNS]

IMO the two techniques are equivalent in terms of outcomes.

The biggest advantage of endoscopic septoplasty is for teaching, since it is much easier for trainees and supervisors to see what is going on. With traditional septoplasty, the only person who can see anything is the person doing the surgery.

I personally find the best way to see if the septum is straight or not is to look from the front of the nose with a speculum. An endoscopic view can be deceiving and you can easily lose the forest for the trees.

 

[resxn]

I agree this is operator dependent. However, in my hands, the visualization and thoroughness allowed by an endoscopic technique is unrivaled by either loupes or just a headlight alone both of which I did in training before migrating to an endoscopic technique 10 yrs ago. I'll never look back unless there's a google glass like development that gets and endoscopic view but frees up my scope hand.

 

[koojo]

We see and learn both techniques in our residency. It's definitely user dependant and outcomes I'm sure are similar. I honestly prefer no loops or endoscope. Which ever technique you use you'll become more proficient at if you do it over and over again.