Objectives We aimed to identify the potential risk factors contributing to the need for revision septoplasty in Omani patients and the best techniques to manage recurrence of deviation. The secondary objective of this study was to address the incidence of revision septoplasty at our institution. Methods A retrospective cohort study was conducted at the main ear, nose, and throat (ENT) tertiary hospital receiving patients from all over Oman. Data was collected from Al Shifa system for patients attending the ENT department either as inpatient or outpatient between 2010 and 2019. Research ethical approval was obtained from the research section of the hospital. Results A total of 907 patients who underwent primary septoplasty were included in the study. Among them, 50 (5.5%) of patients needed a revision surgery. Persistent sites of deviation in revision case were caudal septum (68%), posterior septum (6%), mid septum (16%), and multiple sites (10%). Nasal valve collapse was noted in 52% of revision cases. Most revision were performed using conventional septoplasty (66%), followed by open septorhinoplasty (26%), and closed septorhinoplasty (8%). Surgical techniques varied between spreader graft in 40% of cases, radio frequency of inferior turbinates in 36%, and other techniques included septal batten graft, septal reinforcement graft, augmentation rhinoplasty, and quilting suture. Internal nasal valve collapse was found in 31 revised cases (62%) and it was not initially examined in 45 of the primary cases (89.5%). Statically significant risk factors for revision are allergic rhinitis (OR = 3.167, 95% CI: 1.613–6.218), increased patient age at primary surgery (OR = 1.080, 95% CI: 1.045–1.116), the use of paraffin gauze as nasal pack after primary surgery (OR = 3.162, 95% CI: 1.609–6.216), and interestingly, if primary surgery was performed by a senior surgeon (OR = 1.743, 95% CI: 3.718–7.930). Conclusions The incidence rate of revision septoplasty at our institute is similar to the reported rates globally. Careful management of caudal septal deviation during primary septoplasty is essential to prevent recurrence of obstruction. A significant number of patients who underwent revision septoplasty had nasal valve collapse that was not addressed during the primary surgery. Understanding the possible risk factors leading to the need for revision surgery is crucial for patient counseling and surgical planning.

A Retrospective Analysis of Revision Septoplasty Over 10 Years Period

期刊论文
发表日期：

2025年8月4日

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Bushra Al Kalbani,
AbdulAziz Al Azri

摘要

Objectives

We aimed to identify the potential risk factors contributing to the need for revision septoplasty in Omani patients and the best techniques to manage recurrence of deviation. The secondary objective of this study was to address the incidence of revision septoplasty at our institution.

Methods

A retrospective cohort study was conducted at the main ear, nose, and throat (ENT) tertiary hospital receiving patients from all over Oman. Data was collected from Al Shifa system for patients attending the ENT department either as inpatient or outpatient between 2010 and 2019. Research ethical approval was obtained from the research section of the hospital.

Results

A total of 907 patients who underwent primary septoplasty were included in the study. Among them, 50 (5.5%) of patients needed a revision surgery. Persistent sites of deviation in revision case were caudal septum (68%), posterior septum (6%), mid septum (16%), and multiple sites (10%). Nasal valve collapse was noted in 52% of revision cases. Most revision were performed using conventional septoplasty (66%), followed by open septorhinoplasty (26%), and closed septorhinoplasty (8%). Surgical techniques varied between spreader graft in 40% of cases, radio frequency of inferior turbinates in 36%, and other techniques included septal batten graft, septal reinforcement graft, augmentation rhinoplasty, and quilting suture. Internal nasal valve collapse was found in 31 revised cases (62%) and it was not initially examined in 45 of the primary cases (89.5%). Statically significant risk factors for revision are allergic rhinitis (OR = 3.167, 95% CI: 1.613–6.218), increased patient age at primary surgery (OR = 1.080, 95% CI: 1.045–1.116), the use of paraffin gauze as nasal pack after primary surgery (OR = 3.162, 95% CI: 1.609–6.216), and interestingly, if primary surgery was performed by a senior surgeon (OR = 1.743, 95% CI: 3.718–7.930).

Conclusions

The incidence rate of revision septoplasty at our institute is similar to the reported rates globally. Careful management of caudal septal deviation during primary septoplasty is essential to prevent recurrence of obstruction. A significant number of patients who underwent revision septoplasty had nasal valve collapse that was not addressed during the primary surgery. Understanding the possible risk factors leading to the need for revision surgery is crucial for patient counseling and surgical planning.