scholarly journals Surgical management for inferior turbinate hypertrophy: a narrative review

Author(s):  
Mano Leoni Divya ◽  
Valli Rajasekaran ◽  
D. Y. Raj Prakash

<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>

2015 ◽  
Vol 5 (17) ◽  
pp. 25-30
Author(s):  
Mihai Saulescu ◽  
Codrut Sarafoleanu

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.


2021 ◽  
Vol 8 (30) ◽  
pp. 2778-2783
Author(s):  
Nikhila Rajendran ◽  
Jaya C ◽  
Venugopal M ◽  
Satheesh S

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


2011 ◽  
Vol 49 (1) ◽  
pp. 53-57
Author(s):  
Nimet Ozalp Devseren ◽  
Mustafa Cenk Ecevit ◽  
Taner Kemal Erdag ◽  
Kerim Ceryan

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.


2010 ◽  
Vol 267 (11) ◽  
pp. 1727-1733 ◽  
Author(s):  
George Gindros ◽  
Ilias Kantas ◽  
Dimitrios G. Balatsouras ◽  
Aikaterini Kaidoglou ◽  
Dimitris Kandiloros

2018 ◽  
Vol 56 (214) ◽  
pp. 958-962
Author(s):  
Nain Bahadur Mahato ◽  
Deepak Regmi ◽  
Meera Bista

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.


2014 ◽  
Vol 5 (1) ◽  
pp. ar.2014.5.0077 ◽  
Author(s):  
Paraya Assanasen ◽  
Panyalak Choochurn ◽  
Wish Banhiran ◽  
Chaweewan Bunnag

Radiofrequency inferior turbinate reduction (RFITR) of inferior turbinate hypertrophy (ITH) is an effective way to treat patients with intractable nasal mucosal obstruction. The objective of this study was to assess smell ability, nasal symptoms, inferior turbinate grading (ITG), peak nasal inspiratory flow (PNIF) of patients with chronic rhinitis (CR), and ITH before and after RFITR. Patients with CR and ITH, aged 18–60 years, who underwent RFITR, were prospectively recruited. Smell ability (measured by smell detection threshold [SDT]), visual analog scale (VAS) of nasal symptoms, ITG, and PNIF before and 6–10 weeks after RFITR were compared. Forty-eight subjects were included. All nasal symptoms were significantly decreased after RFITR. After surgery, SDT (tested by phenyl ethyl alcohol) was worsened in 7 patients (14.6%), improved in 8 patients (16.7%), and did not change in 33 patients (68.7%). SDT after RFITR of six patients in the worsened SDT group were still within normal range (> −6.5). There was only one patient whose SDT changed from normosmia to mild hyposmia (–7.25 to −5.38). In the improved SDT group, two of eight patients had obviously better SDT after RFITR, which changed from moderate hyposmia to normosmia (–3.65 to −10; −3.73 to −10), whereas six of eight patients had little better SDT after RFITR. RFITR also significantly reduced ITG and improved PNIF. In conclusion, the treatment of patients with CR and ITH with RFITR significantly improved PNIF, ITG, and nasal symptoms assessed by VAS, although SDT after RFITR could be the same or improved or worsened.


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