Coblation vs Microdebrider-assisted Inferior Turbinoplasty

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.

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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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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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PARTIAL INFERIOR TURBINECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.04.2923 ◽

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

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Surgery for nasal obstruction in inferior turbinate hypertrophy

Romanian Journal of Rhinology ◽

10.1515/rjr-2015-0003 ◽

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.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180425 ◽

2018 ◽

Vol 4 (2) ◽

pp. 362 ◽

Cited By ~ 1

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

Background: 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.Methods: 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. Results: 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 & 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.Conclusions: 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.

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Potassium Titanyl Phosphate Laser Turbinate Reduction in the Management of Allergic Inferior Turbinate Hypertrophy: Our Experience

Allergy & Rhinology ◽

10.2500/ar.2016.7.0151 ◽

2016 ◽

Vol 7 (1) ◽

pp. ar.2016.7.0151 ◽

Cited By ~ 4

Author(s):

Sabarinath Vijayakumar ◽

Shilpa Divakaran ◽

Pradipta Kumar Parida ◽

Suriyanarayanan Gopalakrishnan

Keyword(s):

Transit Time ◽

Medical Management ◽

Inferior Turbinate ◽

Potassium Titanyl Phosphate ◽

Ktp Laser ◽

Turbinate Hypertrophy ◽

The Mean ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

Background Allergic inferior turbinate hypertrophy is one of the most common causes of nasal obstruction. Several surgical methods can be used for the reduction of allergic inferior turbinate hypertrophy refractory to medical management. Herein, we share our experience with a potassium titanyl phosphate (KTP) laser, which is a relatively novel technique for turbinate reduction. Objectives To evaluate the efficacy of KTP laser turbinate reduction in terms of symptomatic improvement and its effect on nasal mucociliary clearance. Methods This study was conducted in the Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India, from November 2012 to July 2013. Thirty patients with inferior turbinate hypertrophy refractory to medical management were selected. A KTP laser was used at 6 W in continuous mode, with a spot size of 0.6–1 mm, and energy delivered through a 400–μm optical fiber. A follow-up was done at 1 week, 1 month, and 3 months. All the values (both by the Sino Nasal Outcome Test scoring system and saccharine transit time) were assessed before surgery and at each follow-up visit. Results The patients showed significant differences in the symptoms (p < 0.0001) at each follow-up. The mean saccharin transit time showed significant prolongation during the first week and first month after surgery, which indicated adverse effects on the mucociliary system (p < 0.0001). This, however, was a temporary effect, and the mean saccharin time returned to normal limits (17.96 minutes) at the third postoperative month. The mean operative time was 11.62 minutes. The procedure was not associated with any serious intra- or postoperative complications. Conclusion KTP laser turbinate reduction is a safe, effective, and minimally invasive procedure in the treatment of allergic inferior turbinate hypertrophy, with a minimal effect on the nasal mucosa. It can be done as an office procedure, with minimal complications.

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Powered endoscopic inferior turbinoplasty: clinical study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175608 ◽

2017 ◽

Vol 4 (1) ◽

pp. 24

Author(s):

Sajad Al-Helo ◽

Hasanain Falih ◽

Ahmed Jumma

Keyword(s):

Nasal Obstruction ◽

Inferior Turbinate ◽

Turbinate Hypertrophy ◽

Common Complaint ◽

Common Causes ◽

Scale Scores ◽

The Common ◽

Inferior Turbinate Hypertrophy ◽

Turbinate Reduction

Background: Nasal obstruction is a common complaint in ENT clinics and significantly affect the patient`s quality of life. Inferior turbinate hypertrophy is one of the common causes of nasal obstruction, surgical reduction of inferior turbinate is indicated in refractory cases not responding to conservative measures and the optimal surgical technique is controversial. The aim of the study was to evaluate the clinical outcomes of powered endoscopic inferior turbinoplasty in the management of inferior turbinate hypertrophy. Methods: An interventional study (single group clinical trial) was conducted and powered endoscopic inferior turbinoplasty was performed on 30 patients complaining of chronic nasal obstruction due to inferior turbinate hypertrophy and other causes of nasal obstruction were excluded. Results: Assessed preoperatively and 1st week, 1st month and 3rd month postoperatively depending on subjective visual analogue scale scores for nasal obstruction, endoscopic grading system and complications. There was significant improvement in nasal obstruction and significant reduction in inferior turbinate size and mild complications that completely absent at the third month following the surgery. Conclusions: Microdebrider-assisted inferior turbinoplasty as a safe, effective and reliable alternative method for inferior turbinate reduction.

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Comparative assessment of monopolar and bipolar radiofrequency surgery of inferior turbinate

Otolaryngologia Polska ◽

10.5604/01.3001.0008.2768 ◽

2016 ◽

Vol 70 (4) ◽

pp. 22-27

Author(s):

Hasan Emre Koçak ◽

Bengül Altaş ◽

Salih Aydın ◽

Ümit Taşkın ◽

Mehmet Faruk Oktay ◽

...

Keyword(s):

Nasal Obstruction ◽

Inferior Turbinate ◽

Symptom Improvement ◽

Early Symptom ◽

Turbinate Hypertrophy ◽

Postnasal Drip ◽

Significant Difference ◽

Inferior Turbinate Hypertrophy

Objective: The aim of this study was to compare early outcomes of monopolar (MP) and bipolar (BP) radiofrequency (RF) treatment of inferior turbinate hypertrophy from the perspective of both the patient and the surgeon. Study design: Prospective, randomized, single-blind study. Materials and Methods: Seventy-one patients with inferior turbinate hypertrophy resistant to medical treatment. BP RF was used in 36 patients and MP RF in 35 patients, respectively. Patients received no other treatment during a 6-month follow-up. They were evaluated for symptoms such as nasal obstruction severity, nasal obstruction frequency, postnasal drip, nasal crusting, hyposmia, patient satisfaction, and preoperative pain with the use of a visual analogue scale (VAS) before surgery and then 1 and 7 days as well as 1, 3, and 6 months after surgery. Results: No significant difference was observed regarding symptoms of patients after BP and MP inferior turbinate RF surgery in a long-term follow-up. Patients treated with MP RF showed early symptom improvement on days 1 and 7 days after surgery compared to the BP group. Procedure duration of MP RF was longer than that of BP RF. Pain during surgery was reported more frequently in the BP group. Conclusion: MP and BP RF treatment showed no difference in long-term efficacy. However, MP RF therapy was associated with early symptom improvement and less pain reported by patients in comparison to the BP RF group.

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Argon Plasma Surgery for Treatment of Inferior Turbinate Hypertrophy: A Long-Term Follow-Up in 157 Patients

ORL ◽

10.1159/000073116 ◽

2003 ◽

Vol 65 (4) ◽

pp. 206-210 ◽

Cited By ~ 9

Author(s):

E. Ferri ◽

E. Armato ◽

S. Cavaleri ◽

P. Capuzzo ◽

F. Ianniello

Keyword(s):

Argon Plasma ◽

Inferior Turbinate ◽

Turbinate Hypertrophy ◽

Long Term Follow Up ◽

Inferior Turbinate Hypertrophy

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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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