COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

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A prospective study of deviated nasal septum giving rise to other ENT pathologies

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200142 ◽

2020 ◽

Vol 6 (2) ◽

pp. 303

Author(s):

S. Ranga Pradheep Kumar ◽

Seema V. Patel

Keyword(s):

Prospective Study ◽

Nasal Obstruction ◽

Nasal Septum ◽

Septal Deviation ◽

Deviated Nasal Septum ◽

Female Ratio ◽

Nasal Symptoms ◽

Group A ◽

Group B ◽

A Prospective Study

Background: The deviated nasal septum (DNS) is a commonly occurring clinical condition that often causes nasal obstruction. This study, included two groups of subjects 100 each. The group A consists of subjects having DNS with nasal symptoms. The group B consists of subjects having DNS without nasal symptoms but with ear and throat symptoms. The present study makes an effort to review the types and its associated pathology.Methods: A prospective study was carried out in the Department of ENT, Government Medical College and Hospital, Nagpur from September 2016 to October 2018. Data was collected and analysed. Results: The mean age 31.17 years in group A and 30.07 years in group B, with male to female ratio of 1.17:1 in group A and 1.04:1 in group B. Left-sided septal deviation was more common than right-sided deviation. The most common symptoms in group A was nasal obstruction (94%) and in group B was otorrhoea (80%)."C" shaped DNS was the most common type in both the groups. Out of total 200 subjects comprising both the groups, 70 (35%) subjects had significant sinonasal disease, 138 (69%) subjects had ear pathology, 69 (34.5%) had Eustachian tube dysfunction, 35 (17.5%) had throat pathology. In this study, “S” shaped deviation was more prone to be associated with ENT pathology.Conclusions: “S” shaped DNS was maximally associated with sinonasal pathology and there was a high correlation between the side of septal deviation to the side of ear pathology, particularly in asymptomatic DNS.

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Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00024-2 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Ashraf Ali El-Demerdash ◽

Essam Abdel Wanees Beheiry ◽

Sherif Maher El-Aini ◽

Asmaa Shams El-Dein Mohamed ◽

Ahmed Mohamed Ibrahim Khattab

Keyword(s):

Layer Thickness ◽

Nasal Septum ◽

Inferior Turbinate ◽

Military Hospital ◽

Deviated Nasal Septum ◽

Nasal Turbinate ◽

Egyptian Patients ◽

Mucosal Layer ◽

Group A ◽

Group B

Abstract Background The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients. Methods Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital. Results By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B. Conclusion The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.

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Anterior Trimming vs Outer Displacement of Inferior Turbinate: A Comparative Study at a Tertiary Care Hospital

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2021.11.3.654 ◽

1969 ◽

Vol 11 (3) ◽

pp. 169-174

Author(s):

Habib-Ur-Rehman ◽

Fazal-I-Wahid ◽

BakhtZada ◽

Muhammad Javaid ◽

Naseemul Haq

Keyword(s):

Comparative Study ◽

Nasal Obstruction ◽

Objective Assessment ◽

Tertiary Care ◽

Adhesion Formation ◽

Inferior Turbinate ◽

Care Hospital ◽

Female Ratio ◽

Significant Difference ◽

Group A

Background: Obstruction of nose due to enlargement of inferior turbinate is a very common problem faced by ENT surgeon.In thisstudy a usefultechnique for treatment of inferior turbinate hypertrophy is described.Objective:To determine the surgical outcome and complications ofthe two surgicalprocedures.Material and Methods: This non-randomized comparative study was performed in the Department of ENT, HNS, MTI/LRH,Peshawar, Pakistan, from June 01, 2017 to May 31, 2018. After ethical approval, sample size of 112 was calculated and patientsincluded of both genders fulfilling inclusion criteria. After taking consent patients were equally divided into two groups with nonrandom number table method. Both subjective and objective assessment was carried out and observations were recorded on apredesignedproforma.Data were analyzed using SPSS 20.Results: Total patients were 112,in age range from 16 to 50 years. There were 56(50%) patients in each group.Maleswere 71 andfemale 41withmale to female ratio of 1.7:1 and mean age was 32.92+S.D 10.29 years.Relief from nasal obstruction obtained was94.64% and 92.86% in Group A and B respectively. Headachewas relived 83.34 % and 88.38% in Group A and B respectively. Thecomplications experienced were post operative bleeding, adhesion formation and crusting 2.6%, 3.5% and 1.78% respectively.Statistics showed no significant difference between the two operations (p >0.05).Conclusion: Both trimming and outer displacement of hypertrophied inferior turbinate are effective procedures for relief of nasalobstruction but there was no significant difference betweenthe two techniques interm of outcome and complications.Keywords:Inferiorturbinate, Hypertrophy, Trimming, Outer displacement. Nasal obstruction

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A comparative study of endoscopic versus conventional septoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203205 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1490

Author(s):

Ramniwas Dhaka ◽

Pooja Arya ◽

Deep Chand ◽

Vivek Samor ◽

Ramchander Bishnoi ◽

...

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Objective Assessment ◽

Posterior Part ◽

Sinus Surgery ◽

Deviated Nasal Septum ◽

Endoscopic Septoplasty ◽

Surgery Patient ◽

Group A ◽

Group B

Background: Deviated nasal septum is one of the common causes of nasal obstruction. Correction of deviated nasal septum has been performed by a variety of techniques of which Septoplasty is the most popular one. With the advent of endoscopes and their successful use in endoscopic sinus surgery endoscopes have been tried in septoplasty for better visualization of posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplasty.Methods: It was a prospective observational study conducted on 50 patients with deviated nasal septum, who presented to ENT department of SPMC, Bikaner, patients were randomly divided equally in two groups for conventional and endoscopic septoplasty respectively. Data collected on a prestructured proforma and results analysed. Results: The study included 50 cases. Postoperatively significant relief from the symptoms of nasal obstruction (82%) in group A and (96%) group B, was seen. In objective assessment at the end of 3 months of surgery, patient had persistent posterior deviation 24% in group A and 3% in group B, spur 12% in group A and 0% in group B.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

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A comparative study of endoscopic versus conventional septoplasty: an analysis of 50 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174330 ◽

2017 ◽

Vol 3 (4) ◽

pp. 1046

Author(s):

Sagar Chandra ◽

Nitish Baisakhiya

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Posterior Part ◽

Surgical Correction ◽

Nasal Discharge ◽

Deviated Nasal Septum ◽

Nasal Endoscope ◽

Endoscopic Septoplasty ◽

Group A ◽

Group B

Background: Nasal obstruction is the most common complaint in ENT practice. Surgical correction of deviated nasal septum has been performed by a variety of techniques of which sub mucous resection and Septoplasty procedures of surgical correction of nasal septum play a prime role in management of patients of nasal obstruction. Nasal endoscope is very useful tool to visualize posterior part of septum and do the surgery more precisely and with less complication as compare to conventional method. The objectives of the study were to compare the outcomes of conventional and endoscopic septoplasty, to evaluate the advantages, disadvantages and complications of both endoscopic and conventional septoplastyMethods: 50 cases (between (Oct. 2014 - March 2016) of deviated nasal septum selected in this prospective study and they were randomly divided equally in 2 groups for endoscopic (A) and conventional (B) septoplasty respectively. Results: The study included 50 cases. Majority of patients in this study were males 84% (n=42) and 16% (n=18) were female. 46% (n=23) patients had DNS to right side and 54% (n=27) patients had left side, anterior deviation (48%). C and S shaped deviations (14%). Spur was present in 22% (n=11) of cases and 10% (n=5) patients presented with thickening. After completing 2 months of follow up 92% (n=23) of group A and 88% (n=22) of group B were relieved from nasal discharge, while nasal obstruction was absent in 96% (n=24) patients of group A and 80% (n= 20) of group B. 4% cases (n=1) in endoscopic septoplasty was having persistent deviated nasal septum and 16% (n=4) patients of conventional septoplasty belong to this group.Conclusions: Endoscopic septoplasty has an obvious edge over the conventional approach due to better illumination which enables to identify the pathology accurately, excise the deviated part of septum precisely and realignment of the cartilage for best results.

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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.

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A randomized clinical study: outcome of submucous resection of compensatory inferior turbinate during septoplasty

Rhinology Journal ◽

10.4193/rhino10.006 ◽

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.

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Partial inferior turbinectomy versus submucosal diathermy in hypertrophied inferior turbinates

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204623 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2011

Author(s):

Smitha S. Gangaraj ◽

Shilpa Thomas

Keyword(s):

Wound Healing ◽

Comparative Study ◽

Nasal Obstruction ◽

Short Term ◽

Mild Pain ◽

Group A ◽

Term Evaluation ◽

Group B ◽

Operative Assessment

Background: The study aims to compare the efficacy of submucosal diathermy and partial inferior turbinectomy in terms of improvement in nasal obstruction, pain, haemorrhage, crusting and wound healing.Methods: A prospective sequentially randomized comparative study involving fifty patients, divided into two groups of 25 patients each. Group A consists of patients who underwent SMD and group B consists of patients who underwent PIT. Post-operative assessment was done at day 1, 2 weeks, 1 month, 3 months and 6 months.Results: Post-operative improvement in nasal obstruction was seen in both groups. 80% showed significant improvement in SMD and 32% in PIT group at the end of second week. By sixth month, 40% in SMD group and 80% in PIT group showed significant improvement. Mild pain was observed in 12% of PIT group at 2 weeks. In SMD group, 8% developed reactionary haemorrhage. In PIT group, 24% developed minimal soakage and 12% developed moderate soakage. Severe nasal crusting was seen in 64% of the cases in PIT group and in 40% of the cases in SMD group at second week. By 1 month, 44% in PIT group and 12% in SMD group showed severe crusting.Conclusions: Short term complications like pain, obstruction and haemorrhage was noted to be higher with PIT. On long term evaluation, PIT showed better results in terms of improvement in nasal obstruction scores.

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A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

10.36106/paripex/7904461 ◽

2020 ◽

pp. 1-3

Author(s):

Akshar Patel ◽

Shashank Desai

Keyword(s):

Laparoscopic Surgery ◽

Comparative Study ◽

Tertiary Care ◽

Needle Insertion ◽

Care Hospital ◽

Open Method ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

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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.

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