Powered Endoscopic Nasal Septal Surgery.

Aderito de Sousa, Livia Iniciarte, Howard Levine

Abstract


While nasal endoscopy is typically used for diagnosis and sinus surgery, endoscopy can be combined with powered instrumentation to perform nasal septal surgery. Powered Endoscopic Nasal Septum Surgery (PENSS) is an easy, effective and quick alternative to traditional headlight approaches to septoplasty. PENSS limits the dissection to the area of the deviation and markedly reduces the extent of subperichondrial dissection. This is particularly valuable in patients who have undergone prior septal cartilage resection. PENSS was used in 2,730 patients over 8 years. Surgical indications and technique are discussed. These patients had either isolated nasal septal deformities associated with other rhinologic pathology (sinusitis, adenoid hypertrophy polyps and external nasal deformity). PENSS was utilized with video assistance to allow an enhanced view of the endoscopic operative field. These patients were operated upon in an outpatient surgical suite and were seen for a post-operative video endoscopic evaluation at 5, 10, 15 and 20 days after surgery. The patients who had associated functional endoscopic sinus surgery were evaluated as needed until 6 weeks after surgery. There were no delayed complications. Endoscopic resection of septal spurs, deformities and deviations can be performed safely alone or in combination with endoscopic sinus surgery with minimal additional morbidity.

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