In Which Situations Is Tomography Required Before Septoplasty Operation?

July 22, 2018

Do nasal tomography is necessary before the septoplasty operation? - Is a paranasal sinus tomography necessary before the septoplasty operation? - Is it necessary to take a nasal tomography before the septum deviation surgery?

In patients who are normally planned to undergo nasal septum deviation correction, routine endoscopic examination performed before surgery, grade of cartilage curvature, and condition of nasal meats are easy to see. However, in the presence of the following conditions, preoperative paranasal sinus tomography is suitable:

• Enlarged middle cone hypertrophy filling the nasal cavity (middle nose growth)

• Nasal polyp presence

• The presence of advanced cartilaginous curvature (especially the presence of anterior septum zone curvature at an advanced level), which complicates or obstructs intranasal examination.

• Presence of chronic sinusitis based on clinical and endoscopic findings (in the above section of the tomography, the right maxillary sinus is completely closed and the soft tissue sinus is completely filled - chronic maxillary sinusitis is seen)

Apart from the above, usually private health insurances require a parasal sinus tomography report to document the pre-operative condition (unfortunately, this causes patients to receive unnecessary radiation). Intra-nasal endoscopic examination, nasal valve region tomography can be evaluated more accurately. Tomography is more advantageous than physical examination, especially in assessing septum deviations in the posterior segment.

Given the costs and exposure to radiation associated with CT, preoperative imaging should only be performed for a specific group.

Below, tomographic images of different sections of a patient with "S" type traumatic septum deviation are shown. Endoscopic examination is difficult because of the deviation in the anterior segment of the septum.