scholarly journals Inferior turbinectomy - outcome of various surgical modalities: a prospective study

2017 ◽  
Vol 3 (3) ◽  
pp. 551
Author(s):  
Rajeev Reddy
Keyword(s):  
Prospective Study ◽  
Radio Frequency ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Small Sample ◽  
Nasal Airway ◽  
Subjective Improvement ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvement. In these circumstances, surgical reduction of inferior turbinate can be proposed. Many different techniques are currently available. The aim of our study is to prospectively evaluate the effectiveness of three techniques i.e., electrocautery, cryotherapy and radio frequency by comparing the response of patients to these surgical modalities of turbinate reduction.</p><p class="abstract"><strong>Methods:</strong> A total of 90 patients presenting with nasal obstruction with or without allergic symptoms, fulfilling the inclusion and exclusion criteria, attending ENT OPD are included in the study. A prospective study was conducted on three groups of thirty patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy of more than 3 months duration. Then the percentage of subjective improvement in nasal airway is used to assess treatment outcomes 1 week, 1, 3, 6, 9 and 12 months after surgery.  </p><p class="abstract"><strong>Results:</strong> At the end of 12 months, 56.6% of patients treated with electrocautery and 56.6% of patients treated with cryotherapy showed 75% improvement in nasal obstruction whereas 59.99% of patients treated with radio frequency showed 100% improvement. No statistical difference in the amount of improvement in nasal obstruction was noted between the three treatment groups at the end of 12 months because of relatively small sample size.</p><strong>Conclusions:</strong> On this basis it is evident that clinically radio frequency showed better subjective improvement in nasal obstruction when compared to cryotherapy and electrocautery.

scholarly journals Benefits of Turbinectomy vs Turbinoplasty – A Prospective Study

2021 ◽  
Vol 29 (2) ◽  
pp. 159-163
Author(s):  
Revathi Thirugnanamani ◽  
Saroj Sahadevan ◽  
Anil Kumar Ramabhadraiah ◽  
Architha Menon P ◽  
Rukmini M Prabhu
Keyword(s):  
Nasal Obstruction ◽  
Symptomatic Relief ◽  
Postoperative Bleeding ◽  
Inferior Turbinate ◽  
Mucosal Injury ◽  
Controlled Study ◽  
Excellent Outcome ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
A Prospective Study

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH.

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.

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 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 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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