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.

Download Full-text

Clinical Outcome of CO2 Laser Inferior Turbinate Reduction in Patients with Nasal Obstruction Due to Inferior Turbinate Hypertrophy in a Tertiary Care Centre, Thiruvananthapuram, Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/510 ◽

2021 ◽

Vol 8 (30) ◽

pp. 2778-2783

Author(s):

Nikhila Rajendran ◽

Jaya C ◽

Venugopal M ◽

Satheesh S

Keyword(s):

Allergic Rhinitis ◽

Clinical Outcome ◽

Medical Treatment ◽

Nasal Obstruction ◽

Co2 Laser ◽

Inferior Turbinate ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

BACKGROUND Nasal obstruction secondary to inferior turbinate hypertrophy significantly affects the quality of life. Patients refractory to medical treatment are taken up for surgery. Laser turbinate reduction is an effective and simple method for treatment of nasal obstruction due to inferior turbinate hypertrophy. Only a few studies reported on the outcome of laser inferior turbinate reduction in India. The present study was done to assess the clinical outcome of laser inferior turbinate reduction in patients with nasal obstruction due to inferior turbinate hypertrophy. METHODS This prospective observational study was done in 31 patients (18 – 60 years) with nasal obstruction due to inferior turbinate hypertrophy refractory to medical management who underwent laser inferior turbinate reduction in ENT Department, Government Medical College, Thiruvananthapuram from December 2017 to September 2019. RESULTS All patients had bilateral inferior turbinate hypertrophy. 21 out of 31 patients had allergic rhinitis and rest had non-allergic rhinitis. Pre-operatively most patients had symptom score between 15 and 20. After CO2 laser inferior turbinate reduction at the end of 3 months of follow up, subjective assessment by symptom scoring confirmed by objective assessment by flowmetry 29 out of 31 patients had good outcome with relief from nasal obstruction. The success rate was more in nonallergic rhinitis (100 %) than the allergic rhinitis group (90.47 %). CONCLUSIONS CO2 laser inferior turbinate reduction is an effective procedure to relieve nasal obstruction in patients with inferior turbinate hypertrophy refractory to medical treatment, with minimal complications. Post-procedure on follow up significant number of patients had relief from hyposmia, sneezing and running nose. KEYWORDS Nasal Obstruction, Peak Nasal Inspiratory Flowmetry, Symptom Scoring, CO2 Laser, Outcome

Download Full-text

Turbinoplasty of hypertrophied inferior turbinate by diode laser

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v16i1.5778 ◽

1970 ◽

Vol 16 (1) ◽

pp. 29-34

Author(s):

Md Rojibul Hoque ◽

Asaduzzaman Rasel ◽

Md Khalid Asad ◽

Moni Lal Aich

Keyword(s):

Diode Laser ◽

Local Anesthesia ◽

Operation Time ◽

Inferior Turbinate ◽

Complete Relief ◽

Clinical Experiences ◽

Short Operation Time ◽

The Mean ◽

Conventional Radiology

Background: Different laser types have been used for the treatment of hypertrophied inferiornasal turbinates. The clinical experiences of its treatment by means of a diode laser are presented.Methods: A total of 45 patients suffering from nasal obstruction due to hypertrophied inferiorturbinates (HIT) were treated with a continuous diode laser (14 W- 940 nm) in "contact" modeand under local anesthesia. Thirty patients (16 with allergic rhinitis and 14 with vasomotorrhinitis) were included into this clinical trial with a follow-up of 6 months. The study wasconducted by a questionnaire, photo documentation, conventional radiology of the paranasalsinuses, and histology.Results: The mean operation time took 8 min/turbinate, no nasal packing was necessary andno immediate complications (e.g., bleeding) were observed. Statistical analysis revealedsignificant subjective improvement (86%) of the nasal airflow and nasal cavity volume (photodocumentation) 6 months after laser surgery. In addition, complete relief of headache wasachieved in 32%. The remission rates of persistent rhinorrhoea and post-nasal dripping were,at about 88% and 64%, respectively. Atrophic change and synechiae had not been observed.Conclusions: Diode laser treatment of HIT is a useful procedure, which can be performed as anoutpatient surgery under local anesthesia, resulting in a controlled coagulation and ablation of thesoft tissue. The short operation time and the good results provide an excellent patient acceptance.Key words: Diode Laser; Hypertrophied Inferior Turbinate; Turbinoplasty.DOI: 10.3329/bjo.v16i1.5778Bangladesh J Otorhinolaryngol 2010; 16(1): 29-34

Download Full-text

A Randomized Controlled Trial of Conbercept Pretreatment before Vitrectomy in Proliferative Diabetic Retinopathy

Journal of Ophthalmology ◽

10.1155/2016/2473234 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Xiaochun Yang ◽

Jianbiao Xu ◽

Ruili Wang ◽

Yan Mei ◽

Huo Lei ◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Controlled Trial ◽

Control Group ◽

Intraoperative Bleeding ◽

Significant Difference ◽

Pars Plana ◽

Effective Adjunct

Purpose.To determine the efficacy and safety of preoperative intravitreal conbercept (IVC) injection before vitrectomy for proliferative diabetic retinopathy (PDR).Methods.107 eyes of 88 patients that underwent pars plana vitrectomy (PPV) for active PDR were enrolled. All patients were assigned randomly to either preoperative IVC group or control group. Follow-up examinations were performed for three months after surgery. The primary bioactivity measures were severity of intraoperative bleeding, incidence of early and late recurrent VH, vitreous clear-up time, and best-corrected visual acuity (BCVA) levels. The secondary safety measures included intraocular pressure, endophthalmitis, rubeosis, tractional retinal detachment, and systemic adverse events.Results.The incidence and severity of intraoperative bleeding were significantly lower in IVC group than in the control group. The average vitreous clear-up time of early recurrent VH was significantly shorter in IVC group compared with that in control group. There was no significant difference in vitreous clear-up time of late recurrent VH between the two groups. Patients that received pretreatment of conbercept had much better BCVA at 3 days, 1 week, and 1 month after surgery than control group. Moreover, both patients with improved BCVA were greater in IVC group than in control group at each follow-up.Conclusions.Conbercept pretreatment could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up and acquiring stable visual acuity restoration for PDR.

Download Full-text

Medicaid Payer Status Is a Predictor of Early Postoperative Pain Following Upper Extremity Procedures

Hand ◽

10.1177/1558944720912565 ◽

2020 ◽

pp. 155894472091256

Author(s):

Michael T. Scott ◽

Allison L. Boden ◽

Stephanie A. Boden ◽

Lauren M. Boden ◽

Kevin X. Farley ◽

...

Keyword(s):

Postoperative Pain ◽

Upper Extremity ◽

Private Insurance ◽

Insurance Status ◽

Preoperative Pain ◽

Pain Scores ◽

Patient Reported ◽

Before And After ◽

Subjective Pain

Background: The purpose of this study was to investigate the relationship between insurance status and patient-reported pain both before and after upper extremity surgical procedures. We hypothesized that patients with Medicaid payer status would report higher levels of pre- and postoperative pain and report less postoperative pain relief. Methods: In all, 376 patients who underwent upper extremity procedures by a single surgeon at an academic ambulatory surgery center were identified. Patient information, including insurance status and Visual Analog Scale pain score (VAS-pain) at baseline, 2 weeks, and 1, 3, and 6 months, were collected. VAS-pain scores were compared with t-tests and linear regression. Results: Preoperatively and at 2-week, 1-month, and 3-month follow-up, Medicaid patients reported statistically significant higher pain levels than patients with Private insurance, finding a mean adjusted increase of 0.51 preoperatively, 0.39 at 1 month, and 0.79 at 3 months. Preoperatively and at 3-month follow-up, Medicaid patients reported statistically significant higher pain than patients with Medicare, finding increases in VAS-pain of 0.99 preoperatively and 0.94 at 3 months. There was no difference in pain improvement between any insurance types at any time point (all P values > .05). Conclusions: Patients with Medicaid report higher levels of preoperative pain and early postoperative pain, but reported the same improvement in pain as patients with other types of insurance. As healthcare systems are becoming increasingly dependent on patient-reported outcomes, including pain, it is important to consider that differences may exist in subjective pain depending on insurance status.

Download Full-text

Diode Laser Reduction of Symptomatic Inferior Turbinate Hypertrophy

Journal of Nepal Medical Association ◽

10.31729/jnma.4005 ◽

2018 ◽

Vol 56 (214) ◽

pp. 958-962

Author(s):

Nain Bahadur Mahato ◽

Deepak Regmi ◽

Meera Bista

Keyword(s):

Diode Laser ◽

Local Anesthesia ◽

Cost Effective ◽

Inferior Turbinate ◽

Symptom Assessment ◽

Nasal Discharge ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

Laser Reduction ◽

Turbinate Reduction

Introduction: Inferior turbinate hypertrophy refractory to medical management is one of the commonest problems encountered by ENT surgeons all over the world. Diode Laser turbinate reduction is a safe, minimally invasive, cost-effective procedure that helps in relieving the symptoms associated with it and can be performed on a day care basis under local anesthesia. The objective of this study is to measure the effectiveness of Diode laser in treatment of symptomatic ITH.Methods: Fifty patients with symptomatic inferior turbinate hypertrophy, age ranging between 15-45 years were enrolled in the study. Symptom assessment was done with the visual analogue scale. Portable Diode laser was used. Patients were followed up after 1 week and 1 month of surgery. During each postoperative visit, symptoms were reassessed using VAS and postoperative morbidity were noted.Results: Out of fifty patients, all the patients had nasal obstruction and 42 had nasal discharge and by the end of 1 month 43 (86%) and 37 (88%) patients had relief of symptoms respectively. Excessive sneezing was found in 45 patients, 39 (86.6%) patients got benefitted. Out of 18 patients, 15 (83.3%) patients had decreased snoring at 1 month post-op. Similarly, 24 patients had headache, 20 (83.3%) patients had decrease in severity. Hyposmia was seen in 19 patients, 10 (52.6%) patients had improvement in olfaction.Conclusions: Diode laser turbinate reduction for symptomatic inferior turbinate hypertrophy is one of the safest procedures that can be done under local anesthesia on OPD basis with significant relief of symptoms and with minimal complications.

Download Full-text

Inferior turbinate reduction by use of Diode Laser. A study on surgical outcome, post-operative crusting, and bleeding

10.53350/pjmhs211571739 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1739-1741

Author(s):

Zafer Iqbal ◽

Shahbaz Mujtaba Ghouri ◽

Rehan Saleem ◽

Aysha Nauman ◽

Muhammad Nadeem ◽

...

Keyword(s):

Diode Laser ◽

Postoperative Period ◽

Surgical Outcome ◽

Inferior Turbinate ◽

Nasal Blockage ◽

Research Hospital ◽

Operative Complications ◽

Almost All ◽

Single Blind ◽

Turbinate Reduction

Objectives: To assess the efficacy of the technique regarding the surgical outcome, post-operative crusting, and bleeding. Design: Single Blind interventional type of study. Study Place and period: This study was conducted at, Chaudhary Muhammad Akram Teaching and Research Hospital Lahore from July 2018 to June 2019. Material and methods: The study included 100 patients and the results of technique in respect to surgical outcome, the safety of technique regarding post-operative complications like crusting in the postoperative period and epistaxis were analyzed. Results: A total of 100 patients were included for research. Their ages were between 10-40 years. It was concluded that almost all the patients had felt improvement in their nasal blockage and postnasal discharge. The sneezing and headache in these patients also have been improved. Ten patients presented with nose crusting and 4 patient presented with mild epistaxis. No acitve intervention was not required in any patient. Conclusion: It was concluded that reduction of inferior turbinate by Diode laser is an excellent, and safe option, regarding the surgical outcome, and complications faced by patients registered for turbinate surgery. Keywords: Turbinates reduction, Diode laser, epistaxis.

Download Full-text

A comparative study between coblation adenoidectomy and conventional adenoidectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181859 ◽

2018 ◽

Vol 4 (3) ◽

pp. 721

Author(s):

V. Saravana Selvan ◽

Muthamil Silambu ◽

D. Vinodh Kumaran

Keyword(s):

Comparative Study ◽

Pain Score ◽

Tertiary Care ◽

Conventional Technique ◽

School Absenteeism ◽

Care Centre ◽

Tertiary Care Centre ◽

Intraoperative Bleeding ◽

Medical College

Background: The objective of the study was to compare the advantages and results between coblation adenoidectomy and conventional adenoidectomy by curettage.Methods: The study was conducted in Stanley medical college, Chennai (a tertiary care centre) from June 2013 to June 2016. Fifty patients were studied who underwent adenoidectomy. Twenty five patients underwent conventional adenoidectomy by curettage and rest by nasal endoscopy assisted coblation adenoidectomy. Following outcomes were evaluated: pain score on first day, days reporting pain, analgesic days, school absenteeism, endoscopic adenoid grading and intraoperative bleeding. Results: Patients who underwent coblation adenoidectomy showed better results during follow up with lesser complications.Conclusions: Coblation adenoidectomy is a better technique when compared to conventional technique of curettage.

Download Full-text

Postoperative pain with or without nasal splints after septoplasty and inferior turbinate reduction

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2020.102667 ◽

2020 ◽

Vol 41 (6) ◽

pp. 102667

Author(s):

Richard H. Law ◽

Alvin B. Ko ◽

Lamont R. Jones ◽

Edward L. Peterson ◽

John R. Craig ◽

...

Keyword(s):

Postoperative Pain ◽

Inferior Turbinate ◽

Turbinate Reduction

Download Full-text

Prospective Randomized Trial Comparing HAL-RAR Versus Excisional Hemorrhoidectomy: Postoperative Pain, Clinical Outcomes, and Quality of Life

Surgical Innovation ◽

10.1177/1553350618822644 ◽

2019 ◽

Vol 26 (3) ◽

pp. 328-336 ◽

Cited By ~ 4

Author(s):

Fernando Carvajal López ◽

Carlos Hoyuela Alonso ◽

Montserrat Juvany Gómez ◽

Daniel Troyano Escribano ◽

Miguel Angel Trias Bisbal ◽

...

Keyword(s):

Quality Of Life ◽

Postoperative Pain ◽

Postoperative Morbidity ◽

Short Form ◽

Controlled Trial ◽

Primary Objective ◽

Artery Ligation ◽

Symptom Resolution

Purpose. To compare outcomes of hemorrhoid artery ligation with recto-anal repair (HAL-RAR) and excisional hemorrhoidectomy (EH). The primary objective was to compare postoperative pain, and the secondary objectives were the following: symptom resolution rates, postoperative morbidity, recurrence, and changes in quality of life. Method. Prospective randomized controlled trial, including 40 patients with grades III-IV hemorrhoids who were allocated 1:1 to HAL-RAR and EH. Follow-up evaluation was performed at 15 days, 30 days, 6 months, 12 months, and then annually. Pain was measured using a Visual Analogic Scale and was self-recorded by patients. Quality of life was measured with Short Form Survey-36 questionnaire. Results. Postoperative pain was lower in the HAL-RAR group during the first 30 postoperative days. Moreover, from day 7 onward more patients in the HAL-RAR group reported complete absence of pain (Visual Analogic Scale score = 0). Globally, symptom resolution was significantly higher ( P = .03) in the HAL-RAR group at day 15. Bleeding resolution was observed earlier in the HAL-RAR group than in the EH group ( P = .04), but no differences in the resolution of prolapse, itching, and soiling were observed during the 30-day follow-up. After a mean follow-up of 15 months (range 12-27 months), no differences in postoperative morbidity and no recurrences were observed. An improvement was observed in all sections evaluated by the Short Form Survey-36 questionnaire with both techniques. Conclusion. HAL-RAR provokes less postoperative pain during a shorter period than EH and achieves resolution of hemorrhoidal symptoms with less postoperative complaints. No differences in morbidity and recurrence rate were observed after 12 months of follow-up.

Download Full-text