Inferior turbinate reduction: Comparing postoperative bleeding between different surgical techniques

Lasers using different wavelengths and delivery systems have been used to reduce the inferior turbinate mass when hypertrophic inferior turbinates obstruct the nasal airway. Different laser systems produce different laser-tissue interactions. This study presents a comparison between three laser systems: CO2, Nd:YAG, and Diode lasers for inferior turbinate reduction surgery, all performed under endoscopic control. A total of 46 patients were randomized into three treatment groups and followed for more than 1 year. Subjective and objective data were collected. Subjective impressions of improved nasal airway was achieved in 41% (Diode), 47% (Nd: YAG) and 57% (CO2) and was not statistically significant. There was more postoperative bleeding in the CO2 laser group, with 3 patients requiring tamponade. The CO2 laser procedure also took longer to perform. These results failed to show a significant difference between the different lasers for inferior turbinate reduction. Overall, the results were not impressive.

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Surgical management for inferior turbinate hypertrophy: a narrative review

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212138 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1076

Author(s):

Mano Leoni Divya ◽

Valli Rajasekaran ◽

D. Y. Raj Prakash

Keyword(s):

Surgical Technique ◽

Surgical Techniques ◽

Inferior Turbinate ◽

Tissue Preservation ◽

Turbinate Hypertrophy ◽

Time Period ◽

Nasal Physiology ◽

Minimal Invasion ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

<p class="abstract">Inferior turbinate hypertrophy can lead to bothersome symptoms of the nose. Inferior turbinate reduction has to be treated surgically for cases, which are refractory to medical treatment. Plethora of surgical techniques have evolved over the recent years to surgically treat inferior turbinate hypertrophy. Yet, there remains a lack of consensus on optimal surgical technique or a cumulative study on the merits and demerits of the surgical procedures performed. The aim of the study was to review 26 articles from time period of January 2000 to January 2021 studied on surgical techniques of turbinate reduction. On reviewing the studies, it was noted that conventional turbinectomy techniques were not preferred by surgeons to avoid chances of severe complications and hence more studies on newer advanced techniques were noted. Among the newer techniques to find an adequate balance between nasal physiology and tissue preservation RFTVR is preferred and is the optimal technique owing to its minimal invasion, performance ease and reduced complications. Most recent studies represent the benefits of RFTVR. </p>

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Surgical Treatment for the Refractory Allergic Rhinitis: State of the Art

Allergies ◽

10.3390/allergies1010005 ◽

2021 ◽

Vol 1 (1) ◽

pp. 48-62

Author(s):

Antonino Maniaci ◽

Milena Di Luca ◽

Ignazio La Mantia ◽

Calogero Grillo ◽

Caterina Maria Grillo ◽

...

Keyword(s):

Allergic Rhinitis ◽

Surgical Techniques ◽

Standard Technique ◽

Inferior Turbinate ◽

Conventional Drug ◽

Surgical Options ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

Nasal obstruction is a frequent disorder that interferes with the daily patient’s quality of life. The key element in the pathophysiology of the disorder is the inferior turbinate hypertrophy related to multiple conditions such as allergic rhinitis (AR). Many patients are managed using conventional drug therapies such as antihistamines, decongestants, and intranasal steroid sprays, anticholinergic agents, mast cell stabilizers, and desensitizing vaccines. When traditional therapy failed to relieve AR symptoms, surgical inferior turbinate reduction (ITR) is indicated. A vast variety of surgical techniques have been reported in the literature for AR such as resectioning, coagulating, and laser procedures. We aimed to revise all surgical options in AR management. We confirm that no ideal standard technique for turbinate reduction has been developed so far regarding the multitude of different surgical procedures. Furthermore, no prospective and comparable long-term studies are present in the literature; it is challenging to recommend evidence-based surgical techniques.

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Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073441 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3441

Author(s):

Baharudin Abdullah ◽

Sharanjeet Singh

Keyword(s):

Recovery Period ◽

Surgical Techniques ◽

Inferior Turbinate ◽

Excessive Bleeding ◽

Medical Treatments ◽

Comprehensive Review ◽

Surgical Interventions ◽

Prolonged Recovery ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

Surgical treatment of the inferior turbinates is required for hypertrophic inferior turbinates refractory to medical treatments. The main goal of surgical reduction of the inferior turbinate is to relieve the obstruction while preserving the function of the turbinate. There have been a variety of surgical techniques described and performed over the years. Irrespective of the techniques and technologies employed, the surgical techniques are classified into two types, the mucosal-sparing and non-mucosal-sparing, based on the preservation of the medial mucosa of the inferior turbinates. Although effective in relieving nasal block, the non-mucosal-sparing techniques have been associated with postoperative complications such as excessive bleeding, crusting, pain, and prolonged recovery period. These complications are avoided in the mucosal-sparing approach, rendering it the preferred option. Although widely performed, there is significant confusion and detachment between current practices and their basic objectives. This conflict may be explained by misperception over the myriad of available surgical techniques and misconception of the rationale in performing the turbinate reduction. A comprehensive review of each surgical intervention is crucial to better define each procedure and improve understanding of the principle and mechanism involved.

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Surgery for nasal obstruction in inferior turbinate hypertrophy

Romanian Journal of Rhinology ◽

10.1515/rjr-2015-0003 ◽

2015 ◽

Vol 5 (17) ◽

pp. 25-30

Author(s):

Mihai Saulescu ◽

Codrut Sarafoleanu

Keyword(s):

Nasal Obstruction ◽

Surgical Techniques ◽

Inferior Turbinate ◽

Nasal Airflow ◽

Subjective Complaint ◽

Turbinate Hypertrophy ◽

Selection For ◽

Inferior Turbinate Hypertrophy ◽

Objective Improvement ◽

Turbinate Reduction

Abstract In the international literature, there is no consensus on patient selection for turbinate surgery. Surgery is usually indicated to the patients on the basis of subjective complaint of nasal obstruction and surgeon´s clinical examination. Although most surgical techniques demonstrate a subjective and objective improvement in postoperative nasal airflow and subjective scores, it is hard to say which technique is best suited for treating inferior turbinate enlargement. Inferior turbinate reduction for nasal obstructive symptoms caused by enlarged turbinates is a useful procedure and is reserved for patients who are not responding to medical treatment or in whom the medical management is contraindicated.

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Inferior turbinate reduction; coblation versus microdebrider - a prospective, randomised study

Rhinology Journal ◽

10.4193/rhino13.183 ◽

2014 ◽

Vol 52 (4) ◽

pp. 306-314

Author(s):

Hassan M. Hegazy ◽

Mohamed R. ElBadawey ◽

Abobakr Behery

Keyword(s):

Patient Satisfaction ◽

Nasal Obstruction ◽

Postoperative Bleeding ◽

Inferior Turbinate ◽

Crust Formation ◽

Randomised Study ◽

Nasal Symptoms ◽

Before And After ◽

Reduction Methods ◽

Turbinate Reduction

Objectives: We prospectively evaluated and compared the safety, subjective and objective efficacy of the coblation and microde- brider for inferior turbinate reduction. Methods: We designed a prospective randomized trial recruiting 70 patients with symptomatic enlarged inferior turbinates. Forty had coblation and 30 had microdebrider. Objectively, we scored each inferior turbinate size from 1 to 3 pre- and post-operatively. Subjectively, patients completed a visual analogue scale (VAS) evaluating their nasal symptoms, before and after surgery. Results: Both techniques resulted in subjective significant improvement in the VAS for nasal obstruction, and other nasal symptoms. Comparing both groups, coblation showed significantly less pain than the microdebrider. Postoperative bleeding and mucosal tears were less frequent with coblation than with microdebrider but this was nonsignificant. Patient satisfaction significantly improved after both techniques. Conclusion: The submucous coblation is as effective as microdebrider for inferior turbinate reduction. It is easily performed with significantly less postoperative pain than the microdebrider. Both techniques produce significant reduction of the size of the turbinates and associated with a satisfactory improvement of the nasal obstruction, nasal secretion, crust formation, itching, sneezing and dryness. The side effects are minimal with both procedures with significant patient satisfaction postoperatively.

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