Surgical interventions for inferior turbinate hypertrophy.

BACKGROUND AND AIM: Nasal obstruction can be induced by various causes; however, inferior turbinate hypertrophy is considered the most frequent cause of this anatomical malfunctioning condition. The current surgical interventional study was focused on comparing the final outcomes of partial inferior turbinectomy (PIT) and powered endoscopic turbinoplasty (PET). SUBJECTS AND METHODS: The criterion followed for deciding the successfulness of each surgical method was the rate of occurrence of postoperative complications such as bleeding, crustation, and atrophic rhinitis. Fifty patients who suffered from nasal obstruction were randomly divided into two groups: PIT group, with 25 patients, of which 15 (52%) were males and 10 were (48%) females, at an average age of 27.40 ± 7.7 years, and PET group, with 25 patients, out of which 14 (48%) were males and 11 (62%) were females, at an average age of 26.68 ± 6.82 years. The surgical operations were performed at the Department of Otolaryngology, Al-Diwaniyah General Teaching Hospital, Diwaniyah City, Iraq, during the period between March 2015 and March 2020. RESULTS: The PET group showed significantly lower incidence (P < 0.05) of bleeding and crustation than those from the PIT group; however, no significant differences (P > 0.05) were observed between PIT and PET in the occurrence of atrophic rhinitis. CONCLUSION: PET showed promisingly less postoperative complications when compared to PIT.

Inferior Turbinate Reduction: Diode LASER or Conventional Partial Turbinectomy?

Hypertrophy of inferior nasal turbinate is one of the most common causes for nasal obstruction (NO). As diode laser has proven to be as effective as any other lasers, our objective was to study various primary outcomes of its use of diode laser like improvement in NO, intraoperative bleeding, postoperative pain, and rapidity of healing. The study was undertaken to compare the various outcomes by diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT). A nonrandomized controlled trial was conducted on 2 groups: One group (30 cases) underwent LTR and PIT was performed in the other group (30 cases). The improvement in NO was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to fifth postoperative day. Lastly, rapidity of healing was evaluated until 6 months. Subjective relief of NO was 90.8% in LTR group, whereas it was 65% in PIT group at 6-month follow-up, which was statistically significant (P < .05). Pain scores were higher until 5 days in PIT group compared to LTR group (P = .0001). Intraoperative bleeding mean scores (milliliters) were 8.03 in LTR group compared to 23.29 in PIT group (P = .00001). Rapidity of healing was faster in LTR group with mean scores of 3.03 weeks in comparison to PIT group where it was 6.33 weeks (P = .00001). Compared to the conventional technique, the outcomes were better with diode laser and caused less morbidity.

Comparative Study of the Effectiveness of sub mucosal Partial Inferior Turbinectomy and Out fracture of Inferior Turbinate in the Nasal Respiratory Function of Rhinoplasty Patients.

INTRODUCTION: The inferior turbinate is a critical and dynamic structure during rhinoplasty in the internal valve. Many surgeons try to preventively reduce its resistance against the path in the post-rhinoplasty period. To this end, the two methods of "sub mucosal partial inferior turbinectomy" and "inferior turbinate out fracture" are compared in the present study. METHODS: In this clinical study, 110 rhinoplasty candidates were randomly divided into two groups, namely sub mucosal partial inferior turbinectomy and out fracture of the inferior turbinate. To assess the complications, the Sino-Nasal Outcome Test (SNOT-22) was used prior to surgical intervention, and 1, 2, 3, 6, and 12 months following the rhinoplasty procedures. RESULTS: Based on the results of this clinical study and according to the SNOT-22 questionnaire, there was no significant difference between the two groups prior to surgery and a month following the surgery (P > 0.05). However, the average SNOT-22 score for the sub mucosal partial inferior turbinectomy group was significantly lower than that of the group with the out fracture of the inferior turbinate, 2, 3, 6, and 12 months following the surgery. CONCLUSION: Both "sub mucosal partial inferior turbinectomy" and "out fracture of inferior turbinate" are effective methods in improving the respiratory function of rhinoplasty patients, yet the former method is more effective than the latter as regards improving the respiratory function of patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Partial inferior turbinectomy in rhinoseptoplasty has no effect in quality-of-life outcomes: A randomized clinical trial.

OBJECTIVE: Evaluate the impact of endoscopic partial inferior turbinectomy (EPIT) associated with primary rhinoseptoplasty on quality-of-life outcomes (QOL), complications, and surgical duration. STUDY DESIGN: Randomized clinical trial. METHODS: Individuals with nasal obstruction aged ≥ 16 years who were candidates for functional and aesthetics primary rhinoseptoplasty were evaluated from March 2014 through May 2015. Eligible participants were randomly allocated to rhinoseptoplasty with or without EPIT (excision of one-third of the inferior turbinates). RESULTS: Fifty patients were studied. Most were Caucasian and had moderate/severe allergic rhinitis symptoms. Mean age was 36 ( ± 14.5) years. Rhinoseptoplasty was associated with improvement in all QOL scores irrespective of turbinate intervention (P < 0.001). Analysis of covariance was conducted to control for potential confounders. There was no difference between the groups in absolute score changes for Nasal Obstruction Symptom Evaluation-Portuguese (NOSE-p) (-50.5 vs. -47.6; P = 0.723), Rhinoplasty Outcome Evaluation (ROE) (47 vs. 44.8; P = 0.742), and all World Health Organization Quality of Life Scale-Abbreviated (WHOQOL-bref) score domains (P > 0.05). There were no differences between the groups regarding presence of the complications. Surgical duration was higher in the EPIT group (212 minutes ± 7.8 vs. 159.1 ± 5.6; P ? 0.001). CONCLUSIONS: Turbinate reduction through EPIT during primary rhinoseptoplasty did not improve short-term general and specific QOL outcomes. The use of EPIT increases surgical time considerably without improving QOL scores. There was no difference in postoperative incidence of complications, suggesting that EPIT is a safe technique. LEVEL OF EVIDENCE: 1b. Laryngoscope, 128:57-63, 2018.

The value of intranasal splints after partial inferior turbinectomy.

To assess the value of using the intranasal septal splint after partial inferior turbinectomy (PIT) surgery. Prospective, randomized comparative study. The study was conducted over a period of 2 years from January 2012 to January 2014 at Minia University hospital, Minia, Egypt. A total of 100 patients underwent bilateral PIT. They were randomly divided into 2 groups. Group A included 50 patients had PIT with intranasal splints and group B included 50 patients had PIT without splints. A comparison was made between the 2 groups regarding the postoperative pain, degree of nasal obstruction and the degree of tissue healing and adhesions formation at 2 time points (2 and 4 weeks postoperatively). At 2 weeks postoperatively: visual analogue score (VAS) for the pain was 5 in group A versus 2.1 in group B (P = 0.01), VAS for nasal obstruction was 6 in group A versus 5 in group B (P = 0.328), 70 % of patients had good healing in group A versus 24 % in group B (P = 0.02). At 4 weeks postoperatively: VAS for the pain was 1.5 in group A versus 1.8 in group B (P = 0.423), VAS for nasal obstruction was 7 in group A versus 6 in group B (P = 0.353), 80 % of patients had good healing in group A versus 54 % in group B (P = 0.03). The use intranasal septal splints after PIT without septal surgery can cause increased postoperative pain in the short term follow-up period with significant evidence of decreasing rates of intranasal adhesions.

Estudo clínico e ultraestrutural pós-turbinectomia inferior parcial / Clinical and ultrastructural study after partial inferior turbinectomy

O presente trabalho refere-se ao estudo dos resultados clínicos e histológicos obtidos após a turbinectomia inferior parcial (TIP), cirurgia indicada no tratamento da obstrução nasal crônica causada pela hipertrofia das conchas nasais inferiores. MATERIAL E MÉTODOS: Foram estudados vinte pacientes, divididos em dois grupos de dez cada (grupos A e B), submetidos à TIP, associada à septoplastia ou não. Os pacientes foram reavaliados clinicamente e histologicamente (com biópsia das áreas regeneradas das conchas inferiores), em dois períodos pós-operatórios diferentes: um grupo após oito a doze meses (grupo A) e outro após dois anos de TIP (grupo B). RESULTADOS: Os resultados clínicos mostraram-se satisfatórios para o alívio da obstrução nasal no grupo A, e insatisfatórios no grupo B. Entretanto, melhores resultados histológicos, com maior recuperação e diferenciação epitelial da mucosa regenerada das conchas inferiores após a TIP foram observados no grupo B, com sua ultraestrutura ciliar normal. CONCLUSÕES: A cirurgia revelou ser eficaz a curto, mas não em médio prazo, apesar da recuperação histológica ter sido importante.

We report clinical and histological results obtained after partial inferior turbinectomy (PIT), surgery indicated for the treatment of chronic nasal obstruction. METHODS: Twenty patients were divided into two groups submitted to PIT plus septoplasty and PIT alone. The patients were reassessed clinically and histologically by means of a biopsy of the regenerated areas in the inferior turbinates at two different times after PIT, i.e., after 8 to 12 months (group A) and after two years (group B). RESULTS: The clinical results proved to be satisfactory for the relief of nasal obstruction in group A and unsatisfactory in group B. However, better histological results with better recovery and epithelial differentiation of the regenerated mucosa of the inferior turbinates after PIT were observed in group B. CONCLUSION: Surgery proved to be effective on a short-term but not on a long-term basis, and histological recovery did not accompany improvement of clinical signs and symptoms.

Comparation of the Efficacy of Chronic Hypertrophic Rhinitis by Partial Inferior Turbinectomy and Semiconductor Laser Surgery / 中国医师杂志

Objective To compare the efficacy of chronic hypertrophic rhinitis by partial inferior turbinectomy and using semiconductor laser surgery .Methods The efficacy of 53 chronic hypertrophic rhinitis patients with partial inferior turbinectomy(groupⅠ) and 62 patients treated with semiconductor laser surgery(groupⅡ) were analyzed retrospectively.Results the total effective rate of the groupⅠ treated by semiconductor laser surgury was 87 1% and groupⅡ treated by partial inferior turbinectomy was 90 4%. There was no significant difference (P