Abstract
AIMS: Nasal septal deviation (NSD) is one of the most common structural abnormalities contributing to nasal obstruction, which significantly affects patients' quality of life. Septoplasty is the surgical procedure of choice to correct NSD. Traditionally performed via an open approach, endoscopic septoplasty has emerged as a minimally invasive alternative. However, there remains ongoing debate regarding the comparative effectiveness, patient satisfaction, and postoperative outcomes of these two techniques. This study aimed to compare the clinical and patient-reported outcomes of conventional versus endoscopic septoplasty using the Nasal Obstruction Symptom Evaluation (NOSE) and the 22-item Sino-Nasal Outcome Test (SNOT-22)questionnaires. METHODS: A prospective, comparative study was conducted on 120 adult patients (60 undergoing conventional septoplasty and 60 undergoing endoscopic septoplasty) with symptomatic NSD. The NOSE and SNOT-22 questionnaires were administered preoperatively and at 1, 3, and 6 months postoperatively. Data analysis included comparisons of symptom scores, complication rates, and correlation with demographic factors. RESULTS: Both groups demonstrated significant improvement in NOSE and SNOT-22 scores at all postoperative follow-up points compared to baseline (p < 0.001). However, patients undergoing endoscopic septoplasty had marginally better symptom relief (lower mean postoperative NOSE and SNOT-22 scores) and fewer postoperative complications compared to those undergoing conventional septoplasty. Operative time was shorter in the conventional group, but overall patient satisfaction at 6 months was higher in the endoscopic group. CONCLUSION: Both conventional and endoscopic septoplasty lead to significant improvements in nasal obstruction and related sinonasal symptoms as measured by NOSE and SNOT-22. Endoscopic septoplasty may offer additional benefits in terms of reduced complication rates and improved patient satisfaction, although conventional septoplasty remains a viable and effective option for correcting NSD. Further larger-scale, long-term studies are suggested to confirm these findings and optimize surgical decision-making.