scholarly journals Nasal septal angle deviation: effect on lateral wall in nasal obstruction

2018 ◽  
Vol 7 (1) ◽  
pp. 90
Author(s):  
Neha Bagri ◽  
Kavirajan K. ◽  
Ranjan Chandra ◽  
Yatish Agarwal ◽  
Neetika Gupta ◽  
...  
Keyword(s):  
Ct Scan ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
P Value ◽  
Lateral Nasal Wall ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy

Background: Deviation of the nasal septum (DNS) refers to the convexity of the septum to one side disturbing the nasal physiology with obstructed nasal breathing leading to lateral nasal wall abnormalities and paranasal sinuses (PNS) mucosal disease. Knowledge of nasal morphological parameters plays an important role in planning successful nasal surgery. Our aim was to evaluate the angle of septal deviation (ASD) on CT scan and study its influence on the lateral nasal wall abnormalities and PNS mucosal disease.Methods: A prospective cross-sectional observational study was conducted on 130 patients with clinical evidence of DNS and chronic sinusitis. The direction and severity of DNS was recorded on CT scan along with evaluation of lateral nasal wall and sinus mucosal abnormalities.Results: Increasing ASD had statistically significant correlation with the lateral nasal wall abnormalities, most commonly, contralateral middle and inferior turbinate hypertrophy (p-value <0.0001). No significant association was found with the incidence of ipsilateral or contralateral osteomeatal complex (OMC) obstruction and sinus mucosal disease.Conclusions: The direction and severity of septal deviation has significant impact on contralateral middle and inferior turbinate hypertrophy. The analysis of these ancillary pathologies can be of great help to the surgeon in better management of patients with nasal obstruction.

scholarly journals Nasal Airway Obstruction: Prevalence and Anatomic Contributors

2018 ◽  
Vol 97 (6) ◽  
pp. 173-176 ◽  
Author(s):  
David W. Clark ◽  
Anthony G. Del Signore ◽  
Roheen Raithatha ◽  
Brent A. Senior
Keyword(s):  
Airway Obstruction ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Lateral Nasal Wall ◽  
Nasal Airway ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
Nasal Valve Collapse ◽  
Surgical Treatments

Surgical treatments for nasal airway obstruction (NAO) are commonly offered as part of otolaryngology practice. Anatomic causes include septal deviation, inferior turbinate hypertrophy, and nasal valve collapse (NVC). This study was performed to determine the prevalence of anatomic contributors to NAO. A total of 1,906 patients with sinonasal complaints were surveyed by 50 otolaryngologists in varying U.S. geographic regions. Patients were first evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) instrument to assess the NAO symptoms and their severity. Physicians then examined patients for the presence of the three anatomic contributors. Presence of septal deviation and turbinate hypertrophy was assessed through an internal nasal exam with direct or endoscopic visualization based on the physician's standard methodology for diagnosis. Presence of NVC was determined by the modified Cottle maneuver. Among all patients surveyed, prevalence was 67% for NVC, 76% for septal deviation, and 72% for inferior turbinate hypertrophy. We found that 64% of the patients (n = 1,211) had severe/extreme NOSE scores (≥55), representing the most likely nasal obstruction candidates for intervention. In these patients, the prevalence of NVC, septal deviation, and inferior turbinate hypertrophy was 73, 80, and 77%, respectively. Eighty-two percent of the 236 patients with severe/extreme NOSE scores who reported prior septoplasty and/or inferior turbinate reduction had NVC. Our study revealed a comparable prevalence of all three anatomic contributors across all patients and the subset with severe/extreme NOSE scores, highlighting the importance of evaluating the lateral nasal wall as a component of NAO treatment strategy.

Septoplasty and compensatory inferior turbinate hypertrophy: a randomized study evaluated by acoustic rhinometry

1993 ◽  
Vol 107 (5) ◽  
pp. 413-417 ◽  
Author(s):  
L. F. Grymer ◽  
P. Illum ◽  
O. Hilberg
Keyword(s):  
Randomized Study ◽  
Inferior Turbinate ◽  
Cross Sectional Area ◽  
Septal Deviation ◽  
Acoustic Rhinometry ◽  
Sectional Area ◽  
Cross Sectional ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
Turbinate Reduction

The present study deals with the indication for inferior turbinate surgery in cases of concomitant anterior septal deviation. We define, by acoustic rhinometry, the characteristics of the obstructed nose and define mucosal turbinate hypertrophy. A random sample of 80 patients with nasal obstruction and anteriorly located septal deviation were objectively evaluated by acoustic rhinometry pre– and post–operatively. All had septoplasty and half were randomly selected to have anterior inferior turbinoplasty performed in the side opposite to the major septal deviation. Severe septal deviation, expressed by a minimal cross–sectional area less than 0.4 cm2 was present in 37 patients. In this group inferior turbinate reduction seems advisable. In the wide side, the minimal cross–sectional area and the cross–sectional areas at 3.3 and 4.0 cm from the nostrils increased in the turbinectomy group and decreased in the non–turbinectomy group after correction of the septal deviation. In the group with less pronounced septal deviation no influence of turbinate reduction could be detected.

scholarly journals Septoplasty and septoplasty with inferior turbinoplasty in the management of nasal septal deviation with inferior turbinate hypertrophy

2020 ◽  
Vol 6 (5) ◽  
pp. 960
Author(s):  
K. Rajashekhar ◽  
K. Parameshwar ◽  
K. P. Goud
Keyword(s):  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Deviated Nasal Septum ◽  
Nasal Septal Deviation ◽  
Turbinate Hypertrophy ◽  
First Pass ◽  
The Mean ◽  
Group 2 ◽  
Inferior Turbinate Hypertrophy

<p class="abstract"><strong>Background:</strong> Nasal obstruction is a highly prevalent problem caused by nasal septal deviation, with or without inferior turbinate hypertrophy. Nasal septoplasty and inferior turbinoplasty can improve the nasal airways. This study was designed to assess the efficacy of septoplasty alone and septoplasty with inferior turbinoplasty in cases having nasal septal deviation with inferior turbinate hypertrophy.</p><p class="abstract"><strong>Methods:</strong> A total 70 cases clinically diagnosed with the deviated nasal septum and inferior turbinate hypertrophy were randomly divided into two groups. Group 1 cases were under septoplasty alone and group 2 cases were under septoplasty with inferior turbinoplasty. Symptom improvement scores was assessed by sino nasal outcome test-20 (SNOT-20).  </p><p class="abstract"><strong>Results:</strong> The mean reduction symptom score of nasal obstruction was 1.73 in septoplasty with inferior turbinoplasty group, while in septoplasty group it was 1.06. The mean reduction symptom score in group 2 was statistically significant. All the cases of group 2 had adequate first pass diagnostic nasal endoscopy (DNE). While in group 1, majority cases had inadequate first pass DNE.  </p><p class="abstract"><strong>Conclusions:</strong> First pass DNE findings were favourable in the cases under septoplasty with inferior turbinoplasty Septoplasty with inferior turbinoplasty is effective in the reduction of nasal obstruction, facial pain, sleep difficulty, decrease in attentiveness and irritability in cases having deviated nasal septum with inferior turbinate hypertrophy.</p>

scholarly journals The Role of Quantic Molecular Resonance (QMR) in the Treatment of Inferior Turbinate Hypertrophy (ITH): Our Experience With Long-Term Follow-Up in Allergic and Nonallergic Rhinitis Refractory to Medical Therapy. Preliminary Results

2021 ◽  
pp. 014556132110015
Author(s):  
Filippo Ricciardiello ◽  
Davide Pisani ◽  
Pasquale Viola ◽  
Raul Pellini ◽  
Giuseppe Russo ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Nonallergic Rhinitis ◽  
Turbinate Hypertrophy ◽  
Group A ◽  
Group B ◽  
Inferior Turbinate Hypertrophy ◽  
Molecular Resonance

Objective: The aim of this study was to assess the long-term effectiveness of quantic molecular resonance (QMR) in the treatment of inferior turbinate hypertrophy (ITH) in allergic and nonallergic rhinitis refractory to medical therapy. Methods: This study enrolled 281 patients, 160 males (56.9%) and 121 females (43.1%), mean age 37.8 ± 4.1 years, range 18 to 71. Fifty-four patients have been lost to follow up and have been therefore excluded from the final analysis. Based on skin prick test results, 69 patients were considered allergic (group A) and 158 nonallergic (group B). All subjects underwent before surgery (T0) and 3 (T1), 12 (T2), 24 (T3), and 36 months (T4) after QMR treatment to: 4-phase rhinomanometric examination, nasal endoscopy evaluation, and visual analogue scale to quantify the subjective feelings about nasal obstruction. Results: Subjective and objective parameters showed statistically significant improvement in both groups. Group B parameters not changed during follow-up, while group A showed significant worsening between T1 and subsequent assessments. T4 outcome indicates a better result in nonallergic patients. Conclusions: In accordance with the literature, our preliminary data validate QMR treatment as a successful therapeutic option for nasal obstruction due to ITH. Nonallergic patients had a very good T4 outcome. Allergic patients showed a worsening trend after 1 year probably due to other causes.

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

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

scholarly journals A randomized clinical study: outcome of submucous resection of compensatory inferior turbinate during septoplasty

2011 ◽  
Vol 49 (1) ◽  
pp. 53-57
Author(s):  
Nimet Ozalp Devseren ◽  
Mustafa Cenk Ecevit ◽  
Taner Kemal Erdag ◽  
Kerim Ceryan
Keyword(s):  
Nasal Obstruction ◽  
Surgical Techniques ◽  
Inferior Turbinate ◽  
Nasal Patency ◽  
Randomized Clinical Study ◽  
Turbinate Hypertrophy ◽  
Group A ◽  
Group B ◽  
Inferior Turbinate Hypertrophy ◽  
Submucous Resection

Background: Septoplasty and/or turbinate surgery are commonly used surgical techniques for the treatment of mechanical nasal obstruction. The aim of this study was to define the effectiveness of submucous resection of a hypertrophied turbinate together with simultaneous septoplasty for the treatment of nasal obstruction. Methods: Forty-two patients with septum deviation and compensatory contralateral inferior turbinate hypertrophy were recruited in this study. The inferior turbinate hypertrophy was diagnosed based on examination. The patients were randomly divided into two groups. In group A, a submucous resection was performed to treat a hypertrophied inferior turbinate, together with a septoplasty. In group B, only a septoplasty was performed. Acoustic rhinometry and rhinomanometry tests were conducted for an objective evaluation of nasal patency. A visual analog scale (VAS) was applied to the patients for the subjective evaluation of nasal obstruction complaints. Results: The application of submucous resection intended to reduce a hypertrophied inferior turbinate led to a distinctive increase in cross-sectional area of nasal patency; however, when the two groups were compared, it was statistically significant only at the post-operative sixth month. There was no difference between the results of rhinomanometry. The subjective symptom scores were better in group A than in group B between the post-operative first to sixth month. Conclusion: Submucous resection of a hypertrophied inferior turbinate is necessary for the treatment of nasal obstruction.

scholarly journals Intranasal findings in unilateral primary acquired nasolacrimal duct obstruction

2019 ◽  
Vol 9 (1) ◽  
pp. 47-51
Author(s):  
Sanjeev Kumar Thakur ◽  
Baleshwar Yadav ◽  
Raj Kumar Bedajit ◽  
Akash Agrahari ◽  
Sanjay Kumar Singh ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Nasolacrimal Duct ◽  
Septal Deviation ◽  
Nasolacrimal Duct Obstruction ◽  
P Value ◽  
Deviated Nasal Septum ◽  
Cross Sectional ◽  
Duct Obstruction ◽  
Turbinate Hypertrophy ◽  
Septal Spur

Background: Primary acquired nasolacrimal duct obstruction (PANDO) is a common entity with associated different types of intranasal abnormalities. The pathogenesis of PANDO is unknown. The objective of the study was to describe the intranasal findings in cases of PANDO and find out any association of these findings to the disease. Methods: A comparative cross-sectional study was designed consisting of 50 cases of unilateral PANDO with epiphora and 50 normal volunteers with no history of epiphora. Nasal Evaluation was done with anterior rhinoscopy and nasal endoscopy. Data was tabulated and analyzed using SPSS version 21. Results: The mean age in the unilateral PANDO group was 33.6 years and 34.5 years in the normal volunteer’s group (P-0.84). Left sided dominance of PANDO was observed in 64% (32/50) cases. The odds of having Nasolacrimal duct (NLD) obstruction was1.6 times more among individuals having septal deviation versus no deviation (95% CI, 0.907–2.78). The laterality of septal deviation was corresponding to the side of NLD obstruction in 91% (31/34) cases. High located DNS was more common in the PANDO group which was significant (P-value 0.012). Turbinate hypertrophy, the presence of septal spur or rhinitis had no significant association with NLD obstruction. Conclusions: Deviated nasal septum (DNS), turbinate hypertrophy, septal spur and rhinitis were the associated intranasal findings in cases of unilateral PANDO. A significant association exists between DNS and PANDO, although a cause and effect relation require further probing.

Evaluation of inferior turbinate hypertrophy in patients with congenital and traumatic nasal septum deviation

2012 ◽  
Vol 126 (8) ◽  
pp. 784-788 ◽  
Author(s):  
A Y Korkut ◽  
F Islim ◽  
S Gulseven Ciftci ◽  
R Dogan ◽  
O Gedikli ◽  
...  
Keyword(s):  
Nasal Septum ◽  
Group Versus ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Septum Deviation ◽  
Turbinate Hypertrophy ◽  
Nasal Septum Deviation ◽  
Traumatic Group ◽  
The Difference ◽  
Inferior Turbinate Hypertrophy

AbstractObjective:To compare mucosal and bony measurements in patients with congenital and traumatic nasal septum deviation and compensatory inferior turbinate hypertrophy.Methods:The study examined 50 patients with nasal septum deviation (25 congenital and 25 traumatic) and compensatory inferior turbinate hypertrophy in the contralateral nasal cavity, confirmed by computed tomography.Results:The study compared inferior turbinate measurements on the concave and convex sides of the septum, in the congenital and traumatic groups. Measurements comprised: the shortest distance from the median line to the medial border of the conchal bone; the distances from the most medial part of the conchal mucosa and the conchal bone to the lateral line; the projection angle of the inferior turbinate; and the widest parts of the whole inferior turbinate and the inferior turbinate conchal bone. The differences between the concave and convex side measurements were compared in the congenital group versus the traumatic group; for three measurements, the difference between these two groups was statistically significant (p < 0.05).Conclusion:The present study findings suggest that the conchal bone has a marked influence on nasal patency in patients with congenital septal deviation. These findings supported the decision to excise the inferior turbinate bone at the time of septoplasty, especially when treating congenital septal deviation.

scholarly journals COMPARISON OF MICRODEBRIDER - ASSISTED TURBINOPLASTY VERSUS ENDOSCOPIC PARTIAL TURBINECTOMY IN CASES OF INFERIOR TURBINATE HYPERTROPHY IN ALLERGIC RHINITIS PATIENTS

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S598-602
Author(s):  
Muhammad Ahmed Khan ◽  
Faiz Ul Hassan Nawaz ◽  
Muhammad Tahir ◽  
Hina Mazhar ◽  
Muhammad Dawood ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Military Hospital ◽  
Turbinate Hypertrophy ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Inferior Turbinate Hypertrophy ◽  
Age Range

Objective: To compare microdebrider-assisted turbinoplasty versus endoscopic partial turbinectomy in cases of inferior turbinate hypertrophy in allergic rhinitis patients in terms of relief/improvement of nasal obstruction, post operative bleeding, crusting and synechie formation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Mardan and Combined Military Hospital Malir, from Jan 2019 to Jan 2020. Methodology: A total of 90 patients of allergic rhinitis with severe nasal obstruction due to bilateral inferior turbinate hypertrophy fulfilling the inclusion exclusion criteria were selected. Cases were randomly divided into two groups of 45 each. Group A cases underwent microdebrider assisted turbinoplasty and Group B cases underwent partial turbinectomy via endoscpic approach. They were comparedin terms of post op bleeding, relief of nasal obstruction, post op crusting & synechie/adhesions. All the data was entered on SPSS-17 and analyzed. Results: Out of 90 cases, there were 43 (47.8%) females and 47 (52.2%) males with age range from 15-65, mean age 37.68 ± 11.56 Years. There was only 1 case of post op bleeding after microdebrider assisted turbinoplasty requiring nasal packing in contrast to 6 cases of post op bleeding after endoscopic partial turbinectomy. On one month post op visit, there was no case of nasal crusting in turbinoplasty group in contrast to 7 of mild and 1 of moderate crusting & 3 synechie/adhesions in endoscopic partial turbinectomy group. Conclusion: Microdebrider-assisted turbinoplasty is associated with less post operative bleeding and synechie formation as compared to endoscopic turbinectomy.

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