Post-operative clinical and radiological assessment after submucosal resection of inferior turbinate and partial inferior turbinectomy

In the past 130 years, many surgical procedures for turbinate reduction have been developed. We analyzed the long-term efficacy of 6 of these surgical techniques (turbinectomy, laser cautery, electrocautery, cryotherapy, submucosal resection, and submucosal resection with lateral displacement) over a 6-year follow-up period. We randomly divided 382 patients into 6 therapeutic groups and surgically treated them at the Department of Otorhinolaryngology of the University of Siena. After 6 years, only submucosal resection resulted in optimal long-term normalization of nasal patency and in restoration of mucociliary clearance and local secretory IgA production to a physiological level with few postoperative complications (p < .001). The addition of lateral displacement of the inferior turbinate improved the long-term results. We recommend, in spite of the greater surgical skill required, submucosal resection combined with lateral displacement as the first-choice technique for the treatment of nasal obstruction due to hypertrophy of the inferior turbinates.

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Comparison of radiofrequency tissue volume reduction and submucosal resection with microdebrider in inferior turbinate hypertrophy

Otolaryngology ◽

10.1016/j.otohns.2007.10.035 ◽

2008 ◽

Vol 138 (2) ◽

pp. 176-181 ◽

Cited By ~ 40

Author(s):

Zeynep Kizilkaya ◽

Kursat Ceylan ◽

Hatice Emir ◽

Ahmet Yavanoglu ◽

Ilhan Unlu ◽

...

Keyword(s):

Inferior Turbinate ◽

Volume Reduction ◽

Tissue Volume ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

Submucosal Resection

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Comparison of the Effectiveness and Safety of Radiofrequency Turbinoplasty and Traditional Surgical Technique in Treatment of Inferior Turbinate Hypertrophy

Otolaryngology ◽

10.1016/j.otohns.2005.08.006 ◽

2005 ◽

Vol 133 (6) ◽

pp. 972-978 ◽

Cited By ~ 65

Author(s):

Matteo Cavaliere ◽

Giampiero Mottola ◽

Maurizio Iemma

Keyword(s):

Surgical Technique ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Turbinate Hypertrophy ◽

Group A ◽

The Difference ◽

Group B ◽

Inferior Turbinate Hypertrophy ◽

Submucosal Resection ◽

And Function

OBJECTIVES: Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Many different techniques are currently available. We prospectively evaluate the safety and effectiveness of radiofrequency volumetric tissue reduction (RFVTR) compared with the traditional surgical technique. METHODS: The study was conducted on 3 groups of 75 patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy refractory to medical therapy. In group A, the turbinoplasty (TP) was performed using the classical surgical submucosal resection; in group B, the RFVTR was applied to inferior turbinate; and group C patients were not treated and served as control subjects. Nasal endoscopy, visual analogue scale (VAS), anterior active positional rhinomanometry, and saccharin tests were used to assess treatment outcomes at the end of week 1 and months 1 and 3 after surgery. RESULTS: Turbinate edema and secretions decreased significantly ( P < 0.05) in groups A and B from 1 month after surgery. The secretions in group A increased temporarily on the seventh day after surgery. Concerning the nasal obstruction and related symptoms, significant improvement was observed at 1 month after treatment in all patients ( P < 0.05) and continued up to 3 months after surgery ( P < 0.0001). Rhinomanometric measurements demonstrated a significant nasal flow increase at 3 months ( P < 0.0001). The nasal mucociliary transport time increased in group A at week 1. The difference among the 3 groups at month 1 was observed not significant. CONCLUSION: In this study, we demonstrated that both RFVTR and TP are effective in improving nasal obstruction and related nasal symptoms. In support of the RFVTR, different factors are important: it can be performed in local anaesthesia; it does not require a nasal package; it does not cause either a change of mucociliary function or an increase of secretions and crusts; and the patient can be discharged immediately after treatment. Therefore, we suggest that the RFVTR offers an efficient, gentle, and function-maintaining alternative to TP. However, because of the short follow-up, future investigations are needed for a more exhaustive evaluation of equivalency of the 2 turbinate procedures. EBM RATING: B-2

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How I Do It: Inferior Turbinectomy: Modified Techniques for Submucosal Resection

Allergy & Rhinology ◽

10.1177/21526567211034736 ◽

2021 ◽

Vol 12 ◽

pp. 215265672110347

Author(s):

Kazuhiro Omura ◽

Kazuhiro Nomura ◽

Teppei Takeda ◽

Norihiro Yanagi ◽

Hiroki Kuroyanagi ◽

...

Keyword(s):

Injection Site ◽

Surgical Procedures ◽

State Of The Art ◽

Inferior Turbinate ◽

Novel Technique ◽

Symptom Evaluation ◽

Suture Thread ◽

Submucosal Resection ◽

Postoperative Quality

Although inferior turbinectomy with submucosal resection effectively reduces the volume of the inferior turbinate, there is room for improvement in surgical procedures. Techniques have been developed to reduce crusting and bleeding while efficiently achieving volume reduction. State-of-the-art procedures pertaining to the local injection site, incision line, exposure of the periosteum, submucosal outfracture of the turbinate bone, trimming of redundant mucosa, and incision line suturing are described. Pre and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores and postoperative inferior turbinate bleeding and crusting were evaluated. For the 18 consecutive patients analyzed, the pre and postoperative NOSE scores were 67.8 ± 14.8 and 16.1 ± 13.0, respectively ( P = .0002). Postoperatively, bleeding was absent, and only minor suture thread crusting was observed in 13 patients. In conclusion, our novel technique improves the effectiveness of surgery as well as the postoperative quality of the inferior turbinate.

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