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

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

2013 ◽  
Vol 26 (1) ◽  
pp. 207-215 ◽  
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.

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

2018 ◽  
Vol 4 (2) ◽  
pp. 362 ◽  
Author(s):  
Datta R. K. ◽  
Ramya B. ◽  
Vinay S. R.
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Effective Technique ◽  
Main Symptom ◽  
Turbinate Hypertrophy ◽  
Group I ◽  
Invasive Method ◽  
Inferior Turbinate Hypertrophy

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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 &amp; 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Coblation vs Microdebrider-assisted Inferior Turbinoplasty

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.

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.

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.

scholarly journals PARTIAL INFERIOR TURBINECTOMY;

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

Efficacy and safety of inferior turbinates coblation in children

2014 ◽  
Vol 128 (S2) ◽  
pp. S48-S54 ◽  
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.

scholarly journals Surgery for nasal obstruction in inferior turbinate hypertrophy

2015 ◽  
Vol 5 (17) ◽  
pp. 25-30
Author(s):  
Mihai Saulescu ◽  
Codrut Sarafoleanu
Keyword(s):  
Nasal Obstruction ◽  
Surgical Techniques ◽  
Inferior Turbinate ◽  
Nasal Airflow ◽  
Subjective Complaint ◽  
Turbinate Hypertrophy ◽  
Selection For ◽  
Inferior Turbinate Hypertrophy ◽  
Objective Improvement ◽  
Turbinate Reduction

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.

scholarly journals Diode Laser Turbinate Reduction in Allergic Rhinitis: A Cross-sectional Study

2018 ◽  
Vol 56 (214) ◽  
pp. 949-952
Author(s):  
Priyanka Gupta ◽  
Toran Kc ◽  
Deepak Regmi
Keyword(s):  
Allergic Rhinitis ◽  
Diode Laser ◽  
Medical Therapy ◽  
Inferior Turbinate ◽  
Cross Sectional Study ◽  
Nasal Discharge ◽  
Cross Sectional ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
Turbinate Reduction

Introduction: Turbinate reduction procedures are recommended for inferior turbinate hypertrophy in allergic rhinitis that fail to respond to medical therapy. Several modalities like turbinectomy, submucosal resection and tissue ablation are available for this purpose. The study aimed to evaluate the effectiveness of diode laser in the treatment of symptomatic inferior turbinate hypertrophy in allergic rhinitis and explore complications related to the procedure.Methods: This descriptive cross-sectional study was carried out in a tertiary care centre. The study enrolled 60 patients with inferior turbinate hypertrophy with failure of medical therapy. Inferior turbinate reduction was performed under local anaesthesia using diode laser. All the patients were evaluated subjectively for various nasal symptoms using visual analogue score scale preoperatively and during postoperative visit at three months.Results: The age ranged from 16 to 47 years with median age of 28 years. Twenty nine were male and thirty one were female. There was significant improvement in symptoms like nasal obstruction, nasal discharge, sneezing and decreased sense of smell. Immediate post-operative pain, crusting and persistent nasal discharge were observed as complications of the procedure. However, there was no incidence of mucosal oedema and synechiae formation in our study.Conclusions: Diode laser turbinate reduction procedure is safe, minimally invasive and effective in relieving the symptoms associated with inferior turbinate hypertrophy in allergic rhinitis resistant to medical therapy and can be performed on a day care basis under local anaesthesia.

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