Use of the Nd-YAG Laser for Inferior Turbinectomy: A comparative study

Nasal obstruction resulting from inferior turbinate hypertrophy was treated by Nd-YAG laser inferior turbinectomy (laser IT). The effectiveness of the procedure was assessed and compared with both functional endoscopic turbinoplasty (turbinoplasty) and conventional partial turbinectomy (conventional IT). Materials and methods A retrospective analytic study was carried out for 53 patients suffering from inferior turbinate hypertrophy. Twenty patients underwent Nd-YAG Laser IT (Group 1), 24 patients underwent turbinoplasy (Group 2) and 9 patients underwent conventional IT (Group 3). Improvement in nasal symptoms were assessed. Intra-operative bleeding, duration of hospital stay, and post-operative medications and instrumentation were compared between the three groups. Results The symptoms of sneezing, hyposmia and rhinorhoea were significantly reduced post-operatively among patients in the three groups and there were no differences statistically between them. The Nd-YAG laser turbinectomy group showed marked reduction in blood loss (average = 12 ml per patient) compared to the turbinoplasy group (average = 181 ml per patient) and conventional IT group (average 201 ml per patient). Hospital stay was much shorter in the laser IT group (average = 0.05 days) compared to Group 2 (1.2 days) and Group 3 (1.3 days). Only one patient in the laser IT group required nasal packing, whereas all patients in the other two groups required nasal packing routinely. Conclusions Nd-YAG laser IT was effective in reducing the symptoms of nasal obstruction, as well as other nasal symptoms without significant complications. The Nd-YAG laser is recommended as an alternative method, when applicable, in treating patients with nasal obstruction resulting from inferior turbinate hypertrophy.

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Septoplasty and septoplasty with inferior turbinoplasty in the management of nasal septal deviation with inferior turbinate hypertrophy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201695 ◽

2020 ◽

Vol 6 (5) ◽

pp. 960

Author(s):

K. Rajashekhar ◽

K. Parameshwar ◽

K. P. Goud

Keyword(s):

Nasal Obstruction ◽

Inferior Turbinate ◽

Septal Deviation ◽

Deviated Nasal Septum ◽

Nasal Septal Deviation ◽

Turbinate Hypertrophy ◽

First Pass ◽

The Mean ◽

Group 2 ◽

Inferior Turbinate Hypertrophy

Background: Nasal obstruction is a highly prevalent problem caused by nasal septal deviation, with or without inferior turbinate hypertrophy. Nasal septoplasty and inferior turbinoplasty can improve the nasal airways. This study was designed to assess the efficacy of septoplasty alone and septoplasty with inferior turbinoplasty in cases having nasal septal deviation with inferior turbinate hypertrophy.Methods: A total 70 cases clinically diagnosed with the deviated nasal septum and inferior turbinate hypertrophy were randomly divided into two groups. Group 1 cases were under septoplasty alone and group 2 cases were under septoplasty with inferior turbinoplasty. Symptom improvement scores was assessed by sino nasal outcome test-20 (SNOT-20). Results: The mean reduction symptom score of nasal obstruction was 1.73 in septoplasty with inferior turbinoplasty group, while in septoplasty group it was 1.06. The mean reduction symptom score in group 2 was statistically significant. All the cases of group 2 had adequate first pass diagnostic nasal endoscopy (DNE). While in group 1, majority cases had inadequate first pass DNE. Conclusions: First pass DNE findings were favourable in the cases under septoplasty with inferior turbinoplasty Septoplasty with inferior turbinoplasty is effective in the reduction of nasal obstruction, facial pain, sleep difficulty, decrease in attentiveness and irritability in cases having deviated nasal septum with inferior turbinate hypertrophy.

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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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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

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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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Nasal septal angle deviation: effect on lateral wall in nasal obstruction

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20185095 ◽

2018 ◽

Vol 7 (1) ◽

pp. 90

Author(s):

Neha Bagri ◽

Kavirajan K. ◽

Ranjan Chandra ◽

Yatish Agarwal ◽

Neetika Gupta ◽

...

Keyword(s):

Ct Scan ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Septal Deviation ◽

P Value ◽

Lateral Nasal Wall ◽

Nasal Breathing ◽

Cross Sectional ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy

Background: Deviation of the nasal septum (DNS) refers to the convexity of the septum to one side disturbing the nasal physiology with obstructed nasal breathing leading to lateral nasal wall abnormalities and paranasal sinuses (PNS) mucosal disease. Knowledge of nasal morphological parameters plays an important role in planning successful nasal surgery. Our aim was to evaluate the angle of septal deviation (ASD) on CT scan and study its influence on the lateral nasal wall abnormalities and PNS mucosal disease.Methods: A prospective cross-sectional observational study was conducted on 130 patients with clinical evidence of DNS and chronic sinusitis. The direction and severity of DNS was recorded on CT scan along with evaluation of lateral nasal wall and sinus mucosal abnormalities.Results: Increasing ASD had statistically significant correlation with the lateral nasal wall abnormalities, most commonly, contralateral middle and inferior turbinate hypertrophy (p-value <0.0001). No significant association was found with the incidence of ipsilateral or contralateral osteomeatal complex (OMC) obstruction and sinus mucosal disease.Conclusions: The direction and severity of septal deviation has significant impact on contralateral middle and inferior turbinate hypertrophy. The analysis of these ancillary pathologies can be of great help to the surgeon in better management of patients with nasal obstruction.

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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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Radiofrequency Inferior Turbinate Reduction Improves Smell Ability of Patients with Chronic Rhinitis and Inferior Turbinate Hypertrophy

Allergy & Rhinology ◽

10.2500/ar.2014.5.0077 ◽

2014 ◽

Vol 5 (1) ◽

pp. ar.2014.5.0077 ◽

Cited By ~ 10

Author(s):

Paraya Assanasen ◽

Panyalak Choochurn ◽

Wish Banhiran ◽

Chaweewan Bunnag

Keyword(s):

Detection Threshold ◽

Inferior Turbinate ◽

Chronic Rhinitis ◽

Turbinate Hypertrophy ◽

Nasal Symptoms ◽

Before And After ◽

Phenyl Ethyl Alcohol ◽

Inferior Turbinate Hypertrophy ◽

Peak Nasal Inspiratory Flow ◽

Turbinate Reduction

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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Inferior turbinectomy - outcome of various surgical modalities: a prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20172582 ◽

2017 ◽

Vol 3 (3) ◽

pp. 551

Author(s):

Rajeev Reddy

Keyword(s):

Prospective Study ◽

Radio Frequency ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Small Sample ◽

Nasal Airway ◽

Subjective Improvement ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

A Prospective Study

Background: Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvement. In these circumstances, surgical reduction of inferior turbinate can be proposed. Many different techniques are currently available. The aim of our study is to prospectively evaluate the effectiveness of three techniques i.e., electrocautery, cryotherapy and radio frequency by comparing the response of patients to these surgical modalities of turbinate reduction.Methods: A total of 90 patients presenting with nasal obstruction with or without allergic symptoms, fulfilling the inclusion and exclusion criteria, attending ENT OPD are included in the study. A prospective study was conducted on three groups of thirty patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy of more than 3 months duration. Then the percentage of subjective improvement in nasal airway is used to assess treatment outcomes 1 week, 1, 3, 6, 9 and 12 months after surgery. Results: At the end of 12 months, 56.6% of patients treated with electrocautery and 56.6% of patients treated with cryotherapy showed 75% improvement in nasal obstruction whereas 59.99% of patients treated with radio frequency showed 100% improvement. No statistical difference in the amount of improvement in nasal obstruction was noted between the three treatment groups at the end of 12 months because of relatively small sample size.Conclusions: On this basis it is evident that clinically radio frequency showed better subjective improvement in nasal obstruction when compared to cryotherapy and electrocautery.

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Comparing the outcome of septoplasty and septoplasty with turbinectomy in patients with deviated nasal septum

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193616 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1185

Author(s):

Nayanna Karodpati ◽

Mayur Ingale ◽

Sharad Rawat ◽

Vinayak Kuradagi

Keyword(s):

Nasal Obstruction ◽

Nasal Septum ◽

Inferior Turbinate ◽

Symptom Improvement ◽

Deviated Nasal Septum ◽

Medical College ◽

Turbinate Hypertrophy ◽

Symptom Evaluation ◽

Postoperative Symptoms ◽

Inferior Turbinate Hypertrophy

Background: Deviated nasal septum is a bodily disorder results in nasal obstruction. Many surgical procedures are available in correcting the disorder. The present study aimed to compare the surgical outcome of septoplasty alone and septoplasty with turbinectomy in patients with deviated nasal septum.Methods: This prospective study was done on 50 patients attending to the department of ENT of Dr. D. Y. Patil Medical College and Hospital, DPU with complaints of nasal obstruction due to inferior turbinate hypertrophy with deviated nasal septum. The severity of nasal obstruction was assessed by NOSE (nasal obstruction symptom evaluation) scale. Of them, 25 patients were managed with septoplasty alone and other 25 patients with septoplasty and turbinectomy. The outcome of both the procedures was assessed statistically by using NOSE scale. Results: Postoperative symptom improvement was seen in the both groups following surgery (p<0.05). When the NOSE scores are compared between two groups, statistically significant improvement in the symptoms (NOSE score) was seen in the group of patients treated with septoplasty and turbinectomy compared to septoplasty alone (p<0.05).Conclusions: This study re-iterates both septoplasty and concurrent turbinectomy are established mode of treatment in deviated nasal septum along with hypertrophy of inferior turbinates when the preoperative and postoperative symptoms are compared. However, the symptomatic outcomes and diagnostic nasal endoscopic findings are significantly better in patients who underwent septoplasty with concurrent resection of the inferior turbinate.

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Degloving of the inferior turbinates: pilot study to assess the effectiveness of a new technique in turbinate reduction

The Journal of Laryngology & Otology ◽

10.1258/002221503322542863 ◽

2003 ◽

Vol 117 (11) ◽

pp. 866-870 ◽

Cited By ~ 7

Author(s):

E. B. Chevretton ◽

C. Hopkins ◽

I. M. Black ◽

P. Tierney ◽

N. C. Smeeton

Keyword(s):

Pilot Study ◽

Nasal Obstruction ◽

Controlled Trial ◽

Statistical Significance ◽

Inferior Turbinate ◽

Nasal Symptoms ◽

Postnasal Drip ◽

Nasal Inspiratory Peak Flow ◽

A New Technique ◽

Inferior Turbinate Hypertrophy

A pilot study to assess the safety and efficacy of ’degloving’ of the inferior turbinate is described. This prospective study reports on the effectiveness of the technique in 37 patients with nasal obstruction due to inferior turbinate hypertrophy. Both objective and subjective measurements of nasal patency were made pre-operatively, and repeated at six weeks, six months and two years post-operatively using nasal inspiratory peak flow rates, saccharin clearance time and an end referenced visual analogue scale to record nasal symptoms.There was a significant improvement in the peak inspiratory flow at six weeks (96.4 to 151.2 l/min) and at six months (148.4 l/min), which was sustained at two years (117.1 l/min, p<0.001). There was an overall improvement in patient satisfaction with nasal symptoms (23.4 to 76.7, 76.8 and 66.8 at six weeks, six months and two years, p<0.001) and a decrease in the sensation of nasal obstruction (71.9 to 21.5, 32.9 and 29.8, p<0.001), which was also sustained. Rhinorrhoea was reduced, and sense of smell increased across the group, but the improvements did not reach statistical significance. The results for postnasal drip and saccharin clearance did not show a significant change over the period of the study. There were no haemorrhagic complications in the group studied.This pilot study demonstrates a new surgical technique for reduction of the inferior turbinates, that yields significant improvement in nasal obstruction, an acceptably low complication rate and is well tolerated by patients. A randomized controlled trial is being planned.

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