Comparative study between partial inferior turbinectomy and submucosal diathermy for treatment of inferior turbinate hypertrophy due to allergic rhinitis

Background: Nasal obstruction due to inferior turbinate hypertrophy is one of the most common symptoms of Allergic rhinitis (AR) which causes significant debility. Surgery is one of the modalities of treatment to relieve patients of nasal obstruction. Objective of the study was to evaluate the efficacy of submucosal diathermy (SMD) and partial inferior turbinectomy (PIT) in the treatment of hypertrophied inferior turbinate.Methods: Sixty patients with allergic rhinitis and hypertrophied inferior turbinates were randomised into two groups with thirty patients each (group I underwent SMD and group II underwent PIT). They were assessed for relief of nasal obstruction by subjective and objective methods. Results: Nasal obstruction due to hypertrophy of inferior turbinate was the main symptom with 45 (75%) patients having severe obstruction and 15 (25%) patients moderate obstruction. Both the surgical procedures were effective in reducing nasal obstruction & other symptoms of AR. Though the total symptom score was significantly reduced by both the methods (p=0.001) SMD was superior in relieving nasal obstruction at 3months follow up while PIT was more effective at 6 months follow up.Conclusions: SMD is an easier, less invasive method with lesser postoperative discomfort and complications as compared to PIT. Our study recommends SMD as an effective technique for relief of nasal obstruction in allergic rhinitis.

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

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

Ear Nose & Throat Journal ◽

10.1177/01455613211001599 ◽

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.

Download Full-text

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

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4121 ◽

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.

Download Full-text

PARTIAL INFERIOR TURBINECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.04.2923 ◽

2008 ◽

Vol 15 (04) ◽

pp. 512-517

Author(s):

TAHIR MANZOOR ◽

ADNAN ASGHAR ◽

SOHAIL ASLAM ◽

Muhammad Ali ◽

Waqas Ayub

Keyword(s):

Nasal Obstruction ◽

Visual Analogue Score ◽

Inferior Turbinate ◽

Neck Surgery ◽

Atrophic Rhinitis ◽

Complete Relief ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

Study Setting

Objective: To assess the effectiveness of partial inferior turbinectomy in relieving the symptoms of nasal obstruction in casesof inferior turbinate hypertrophy and to compare the results in terms of relief from nasal obstruction in response to total inferior turbinectomy.Design: Comparative Study. Setting: Department of Otorhinolaryngology and Head and neck surgery, CMH Rawalpindi. Period: From January2004 to November 2004. Patients and Methods: A total of 60 patients with inferior turbinate hypertrophy were selected by convenientsampling. 30 patients were treated by partial inferior turbinectomy and 30 by total inferior turbinectomy and result in terms of relief of nasalobstruction based on VAS (Visual Analogue Score) was observed with follow up carried out at interval of one week and then two months.Results: All cases of both the groups showed complete relief of nasal obstruction after 02 months, showing 100% results. Out of 30 casesmanaged by total inferior turbinectomy 4 cases (13%) developed atrophic rhinitis. Conclusion: Partial inferior turbinectomy is as good as totalinferior turbinectomy in relieving nasal obstruction with an edge of avoiding complications like atrophic rhinitis

Download Full-text

The Role of Nasal Cytology in the Management of Inferior Turbinate Hypertrophy

International Journal of Immunopathology and Pharmacology ◽

10.1177/039463201302600120 ◽

2013 ◽

Vol 26 (1) ◽

pp. 207-215 ◽

Cited By ~ 1

Author(s):

M. Cassano ◽

A. Maselli Del Giudice ◽

G. Russo ◽

L. Russo ◽

G. Ciprandi

Keyword(s):

Allergic Rhinitis ◽

Mast Cells ◽

Medical Treatment ◽

Failure Rate ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Turbinate Hypertrophy ◽

Nasal Cytology ◽

Non Allergic Rhinitis ◽

Inferior Turbinate Hypertrophy

Inferior turbinate hypertrophy (ITH) is the main cause of nasal obstruction symptom. This study aimed at investigating whether a particular cellular pattern could be a predictive factor for failure of medical treatment for ITH in patients with rhinitis. Globally, 258 patients with chronic nasal obstruction due to ITH were evaluated by: visual analogue scale assessment of symptoms, skin prick tests, fiber-endoscopy, active anterior rhinomanometry, and nasal cytology. All patients were treated with drugs for 3 months and then re-evaluated. The symptom improvement depended on the different cellular pattern. There was improvement in: 54 (51.4%) patients with allergic rhinitis, 72 (69.2%) with non-allergic rhinitis with neutrophils (NARNE), 15 (42.8%) with non-allergic rhinitis with eosinophils (NARES), and 9 (64.3%) with non-allergic rhinitis with mast cells/non-allergic rhinitis with eosinophils and mast cells (NARMA/NARESMA). The non-responders (108; 41.9%) were therefore directed towards surgical treatment. Both patients with allergic rhinitis and patients affected by NARES had a higher failure rate to medical treatment compared with NARMA and NARESMA groups (p<0.01). In conclusion, elevated number of eosinophils, in the nasal secretion of both allergic (allergic rhinitis) and non-allergic (NARES) patients with ITH, can be associated to a higher medical treatment failure rate.

Download Full-text

Efficacy and safety of inferior turbinates coblation in children

The Journal of Laryngology & Otology ◽

10.1017/s0022215114000206 ◽

2014 ◽

Vol 128 (S2) ◽

pp. S48-S54 ◽

Cited By ~ 6

Author(s):

M A Bitar ◽

A A Kanaan ◽

S Sinno

Keyword(s):

Allergic Rhinitis ◽

Nasal Obstruction ◽

Statistical Significance ◽

Inferior Turbinate ◽

Rank Test ◽

Safe Procedure ◽

Signed Rank ◽

Signed Rank Test ◽

Inferior Turbinate Hypertrophy

AbstractObjective:To assess the effectiveness and safety of coblation in relieving inferior turbinate hypertrophy in children.Methods:An observational cohort study was undertaken. The severity of allergic rhinitis and the severity and degree of nasal obstruction were assessed using subjective and clinical symptom grading tools, a visual analogue scale, and endoscopy. Any post-operative complications were noted at 1 week, and at 1, 3, 6 and 12 months post-operatively. Data from extended follow-up periods were included when available. The statistical significance of changes in parameter values was assessed using the Wilcoxon signed-rank test.Results:Thirty-two patients were recruited (mean age, 11.28 years; range, 6–17 years). Significant post-operative improvement (p < 0.001) was noted in the severity and degree of nasal obstruction. This improvement was maintained after a mean follow-up period of 10.5 months (range, 1 month to 4 years). No mucosal ulceration or adhesion was encountered. Minimal crusting was noted in 8.57 per cent of patients at 1-week follow up. Allergic rhinitis symptoms improved significantly.Conclusion:Inferior turbinate reduction by coblation is an effective and safe procedure in children aged six years and older. The positive outcomes seem to be long-lasting.

Download Full-text

Coblation vs Microdebrider-assisted Inferior Turbinoplasty

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1227 ◽

2016 ◽

Vol 8 (2) ◽

pp. 51-52

Author(s):

Amit Goyal ◽

Amit Kumar ◽

Rahul K Singh

Keyword(s):

Sample Size ◽

Nasal Obstruction ◽

English Language ◽

Inferior Turbinate ◽

Exclusion Criteria ◽

Turbinate Hypertrophy ◽

Comprehensive Search ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

ABSTRACT Aim The aim of this study is to compare the effectiveness of coblation and microdebrider-assisted turbinoplasty in reducing nasal obstruction due to inferior turbinate hypertrophy (ITH). Background A comprehensive search of articles in English language was performed in PubMed using the keywords coblation turbinoplasty, coblation inferior turbinate reduction, microdebrider turbinoplasty, microdebrider assisted inferior turbinate reduction. Review results Primary search yielded 41 results with only two fulfilling the inclusion and exclusion criteria. In both studies, patients were assessed objectively as well as subjectively. Improvement in nasal obstruction was similar in both coblation and microdebrider groups up to 6 months of follow-up in both studies. However, in the study by Lee and Lee (2006) at 12 months postoperative follow-up, microdebrider-assisted turbinoplasty patients showed a better improvement in nasal obstruction both objectively on acoustic rhinometry and subjectively as compared with the coblation group (p < 0.05). Conclusion Despite getting better results with microdebriderassisted turbinoplasty in one of the study, it can be safely concluded that longer postsurgical follow-up period with bigger sample size is required to adequately comment on the extra benefit offered by either coblation or microdebrider. Clinical significance As and when further research is planned on comparing benefits of different powered instruments for turbinate reduction, it will be wise to prolong the follow-up period with increased sample size. How to cite this article Kumar A, Goyal A, Singh RK. Coblation vs Microdebrider-assisted Inferior Turbinoplasty. Int J Otorhinolaryngol Clin 2016;8(2):51-52.

Download Full-text

Comparative assessment of monopolar and bipolar radiofrequency surgery of inferior turbinate

Otolaryngologia Polska ◽

10.5604/01.3001.0008.2768 ◽

2016 ◽

Vol 70 (4) ◽

pp. 22-27

Author(s):

Hasan Emre Koçak ◽

Bengül Altaş ◽

Salih Aydın ◽

Ümit Taşkın ◽

Mehmet Faruk Oktay ◽

...

Keyword(s):

Nasal Obstruction ◽

Inferior Turbinate ◽

Symptom Improvement ◽

Early Symptom ◽

Turbinate Hypertrophy ◽

Postnasal Drip ◽

Significant Difference ◽

Inferior Turbinate Hypertrophy

Objective: The aim of this study was to compare early outcomes of monopolar (MP) and bipolar (BP) radiofrequency (RF) treatment of inferior turbinate hypertrophy from the perspective of both the patient and the surgeon. Study design: Prospective, randomized, single-blind study. Materials and Methods: Seventy-one patients with inferior turbinate hypertrophy resistant to medical treatment. BP RF was used in 36 patients and MP RF in 35 patients, respectively. Patients received no other treatment during a 6-month follow-up. They were evaluated for symptoms such as nasal obstruction severity, nasal obstruction frequency, postnasal drip, nasal crusting, hyposmia, patient satisfaction, and preoperative pain with the use of a visual analogue scale (VAS) before surgery and then 1 and 7 days as well as 1, 3, and 6 months after surgery. Results: No significant difference was observed regarding symptoms of patients after BP and MP inferior turbinate RF surgery in a long-term follow-up. Patients treated with MP RF showed early symptom improvement on days 1 and 7 days after surgery compared to the BP group. Procedure duration of MP RF was longer than that of BP RF. Pain during surgery was reported more frequently in the BP group. Conclusion: MP and BP RF treatment showed no difference in long-term efficacy. However, MP RF therapy was associated with early symptom improvement and less pain reported by patients in comparison to the BP RF group.

Download Full-text

Nasal Cytology in Radiofrequency Turbinate Volume Reduction

ORL ◽

10.1159/000513629 ◽

2021 ◽

pp. 1-6

Author(s):

Giancarlo Pecorari ◽

Giuseppe Riva ◽

Claudia Bartoli ◽

Mattia Ravera ◽

Valeria Dell’Era ◽

...

Keyword(s):

Allergic Rhinitis ◽

Effective Treatment ◽

Nasal Obstruction ◽

Nasal Mucosa ◽

Inferior Turbinate ◽

Volume Reduction ◽

Nonallergic Rhinitis ◽

Turbinate Hypertrophy ◽

Nasal Cytology ◽

Rhinitis Medicamentosa

Introduction: Radiofrequency turbinate volume reduction (RFTVR) is an effective treatment of inferior turbinate hypertrophy. RFTVR can reduce epithelial cell alterations in nasal mucosa. The aim of this observational study was to evaluate the effects of RFTVR on nasal obstruction and cytology, stratifying for different types of rhinitis. Methods: Nasal cytology and subjective nasal obstruction were evaluated on 113 patients before RFTVR (T0) and after 3 months (T1). The patients were divided into groups on the basis of the underlying disease: allergic rhinitis, nonallergic rhinitis, rhinitis medicamentosa, and other diseases (e.g., hormonal-based turbinate hypertrophy). Results: Nasal cytology at T0 identified 42 patients with allergic rhinitis, 40 with nonallergic rhinitis, 19 with rhinitis medicamentosa, and 12 with other diseases. An improvement of nasal cytology at T1 was observed in 29.2% of cases. They mainly consisted of patients with nonallergic rhinitis with neutrophils, whose neutrophil infiltrate decreased. Only 2 cases (1.7%) showed a worsening of nasal cytology at T1. A statistically significant decrease in subjective nasal obstruction was observed for every group (p < 0.05). Higher differences of nasal obstruction between T0 and T1 were found in patients with rhinitis medicamentosa or other diseases. Conclusion: RFTVR represents a safe and effective treatment for turbinate hypertrophy of various etiology. It is not responsible for a worsening of inflammatory infiltrate of the nasal mucosa.

Download Full-text