Thesis (Ph.D)-Cairo University, 2024.

Bibliography: pages 48-54.

Background: Endoscopic endonasal transsphenoidal surgery, has recently gained popularity , simple and manageable . The ostium to the sphenoid sinus should ideally be clear, allowing easy anatomical alignment and access to the sphenoid sinus.
Objective: The effect of deviated nasal septum on sphenoid sinus exposure in endoscopic endonasal transsphenoid approach and the correlation between the site and angle of deviation of nasal septum with the success of approaching the sphenoid sinus ostium, also determining the needs in performing middle turbinate resection and/or septoplasty .
Methods : This study was conducted at the otorhinolaryngology department at Kasr Al Aini medical hospital as well as the otorhinolaryngology department at 6 October university the study conducted on 30 patients with sphenoid or para sphenoid lesions with septal deviation ,who underwent endoscopic endonasal trans sphenoid approach in the period of 19/9/2022 till 1/12/2023. Preoperative: CT paranasal sinus was performed to all patients to detect the angle of deviation and site of deviation in order to calculate the angle of deviation, a line was drawn from the crista galli to the premaxilla, and a second line was drawn from the crista galli to most prominent point of the septal cartilage at the level of ostiomeatal unit.
Results: the deviation angle cutoff of the nasal septum at 11.5 is a good discriminating with a sensitivity of 90% &specificity of 70%, Area Under the Curve=0.920, p value <0.001, Confidence Interval (0.816-1.000)
Regarding the width cutoff of the nasal cavity at 1.15 may be a discriminating point but not good point with a sensitivity of 85% & specificity = 50%, Area Under the Curve=0.655, p value=0.173, Confidence Interval (0.438-0.872), intervention was done in one third of cases while two third of cases no intervention was done. About 60% of cases underwent septoplasty, 20% of cases underwent MT resection & finally 20% of cases underwent both septoplasty/MT resection
Conclusion : Septal deviations of angle more than 20 degrees affected visibility of the operative bed which mandated intervention to improve the visibility .We concluded that deviation angle is a better predictor than width of the nasal cavity

ﯾﻌﺘﺒﺮ اﺳﺘﺨﺪام ﻣﻨﻈﺎر اﻻﻧﻒ واﻟﺠﯿﻮب اﻻﻧﻔﯿﺔ ﻟﻠﻮﺻﻮل اﻟﻰ ﻓﺘﺤﺔ اﻟﺠﯿﺐ اﻟﻮﺗﺪي ﻓﻲ
ﺟﺮاﺣﺎت ﻗﺎع اﻟﺠﻤﺠﻤﮫ واورام اﻟﻐﺪة اﻟﻨﺨﺎﻣﯿﺔ ﺧﻄﻮه ھﺎﻣﮫ ﺟﺮاﺣﯿﺎ ﻗﺪ ﯾﻌﻮق اﻟﺠﺮاح اﻧﺤﺮاﻓﺎ
ﯾﻤﻨﻊ رؤﯾﺔ ﻓﺘﺤﺔ اﻟﺠﯿﺐ اﻟﻮﺗﺪي ﻣﻤﺎ ﯾﺘﻄﻠﺐ ذﻟﻚ ﺗﺪﺧﻼ ﻻزاﻟﺔ اﻟﺠﺰء
ﺷﺪﯾﺪا ﻓﻲ اﻟﺤﺎﺟﺰ اﻻﻧﻔﻲ
اﻟﺒﺎرز ﻓﻲ اﻟﺤﺎﺟﺰ اﻻﻧﻔﻲ.
ﺳﻨﺔ،
۳٫۳٤±۷۳٫٤۱
اﻟﻤﺸﺎرﻛﯿﻦ
ﻋﻤﺮ
ﺣﺎﻟﺔ، وﻛﺎن ﻣﺘﻮﺳﻂ

ﺷﻤﻠﺖ ھﺬه اﻟﺪراﺳﺔ ۰۳
وﺗﺮاوح ﺑﯿﻦ )٤۱-۲۷ ﺳﻨﺔ.( وﻛﺎن اﻟﻨﻮع اﻷﻛﺜﺮ ﺷﯿﻮﻋﺎً ﻣﻦ اﻧﺤﺮاف اﻟﺤﺎﺟﺰ اﻻﻧﻔﻲ ھﻮ اﻷﻣﺎﻣﻲ
)۷٫٦۷.(% ﺗﻢ اﻟﺘﺪﺧﻞ ﻓﻲ ﺛﻠﺚ اﻟﺤﺎﻻت ﺑﯿﻨﻤﺎ ﻟﻢ ﯾﻜﻦ ھﻨﺎك ﺗﺪﺧﻞ ﺿﺮوري ﻓﻲ ﺛﻠﺜﻲ اﻟﺤﺎﻻت.
ﻣﻦ اﻟﺤﺎﻻت ﺧﻀﻌﺖ
ﻣﻦ اﻟﺤﺎﻻت ﺧﻀﻌﺖ ﻟﺠﺮاﺣﺔ اﻟﺤﺎﺟﺰ اﻷﻧﻔﻲ، و۰۲%
۰٦%
ﺣﻮاﻟﻲ
ﻻﺳﺘﺌﺼﺎل ﻗﺮﻧﯿﺎت اﻻﻧﻒ اﻟﻮﺳﻄﻰ ، وأﺧﯿﺮا ۰۲% ﻣﻦ اﻟﺤﺎﻻت ﺧﻀﻌﺖ ﻟﻜﻞ ﻣﻦ ﺟﺮاﺣﺔ اﻟﺤﺎﺟﺰ اﻷﻧﻔﻲ/ ﻻﺳﺘﺌﺼﺎل ﻗﺮﻧﯿﺎت اﻻﻧﻒ اﻟﻮﺳﻄﻰ. ﻛﺎن ﻣﺘﻮﺳﻂ زاوﯾﺔ اﻧﺤﺮاف اﻟﺤﺎﺟﺰ اﻻﻧﻔﻲ ﻟﻠﻤﺸﺎرﻛﯿﻦ
ﺗﺠﻮﯾﻒ اﻻﻧﻒ ﻟﻠﻤﺸﺎرﻛﯿﻦ
ﻋﺮض
۷۷٫۳۱±٦۱٫٥، وﺗﺮاوح ﺑﯿﻦ )۷-۰۳( وﻣﺘﻮﺳﻂ
٤٤٫۱±۰۳٫۰، وﺗﺮاوح ﺑﯿﻦ )۱-۲.(
ﻟﻘﺪ ﺧﻠﺼﻨﺎ إﻟﻰ أن زاوﯾﺔ اﻻﻧﺤﺮاف ھﻲ ﻣﺆﺷﺮ أﻓﻀﻞ ﻣﻦ ﻋﺮض ﺗﺠﻮﯾﻒ اﻻﻧﻒ
أﺛﺮت اﻧﺤﺮاﻓﺎت اﻟﺤﺎﺟﺰ اﻻﻧﻔﻲ ﻟﻠﺰاوﯾﺔ اﻟﺘﻲ ﺗﺰﯾﺪ ﻋﻦ ۰۲ درﺟﺔ ﻋﻠﻰ رؤﯾﺔ ﻓﺘﺤﺔ اﻟﺠﯿﺐ
اﻟﻮﺗﺪي ﻣﻤﺎ ﯾﺘﻄﻠﺐ اﻟﺘﺪﺧﻞ ﻟﺘﺤﺴﯿﻦ اﻟﺮؤﯾﺔ.
ﯾﻮﺻﻲ اﻟﺒﺎﺣﺜﻮن ﺑﺰﯾﺎدة ﻋﺪد اﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺪراﺳﺎت اﻟﻤﺴﺘﻘﺒﻠﯿﺔ اﻟﺘﻲ ﻗﺪ ﺗﻜﺘﺸﻒ ﺑﯿﺎﻧﺎت
أﻛﺜﺮ أھﻤﯿﺔ ﺣﻮل ﺗﺄﺛﯿﺮ ﻋﺮض ﺗﺠﻮﯾﻒ اﻷﻧﻒ ﻋﻠﻰ اﻟﺤﺎﺟﺔ إﻟﻰ اﻟﺘﺪﺧﻞ. واﻟﺘﻲ ﯾﻤﻜﻦ أن ﺗﻜﻮن ﻧﻘﻄﺔ
ﻣﺜﯿﺮة ﻟﻼھﺘﻤﺎم ﻟﻠﺒﺤﺚ اﻟﻤﺴﺘﻘﺒﻠﻲ

Issues also as CD.

Text in English and abstract in Arabic & English.