Compensatory Hypertrophy of Inferior Turbinate in Cases of Septal Deviation Causing Nasal Obstruction- Intervention Strategies

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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Compensatory hypertrophy of the contralateral inferior turbinate in patients with unilateral nasal septal deviation. A computed tomography study

Otolaryngologia Polska ◽

10.5604/00306657.1149568 ◽

2015 ◽

Vol 69 (2) ◽

pp. 14-20 ◽

Cited By ~ 3

Author(s):

Carlos Chiesa Estomba ◽

Teresa Rivera Schmitz ◽

Carla C Ossa Echeverri ◽

Frank A Betances Reinoso Reinoso ◽

Alejandra Osorio Velasquez ◽

...

Keyword(s):

Computed Tomography ◽

Inferior Turbinate ◽

Compensatory Hypertrophy ◽

Septal Deviation ◽

Nasal Septal Deviation

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Profil Pasien Rinosinusitis Kronik di Poliklinik THT-KL RSUP DR.M.Djamil Padang

Jurnal Kesehatan Andalas ◽

10.25077/jka.v4i3.380 ◽

2015 ◽

Vol 4 (3) ◽

Author(s):

Hesty Trihastuti ◽

Bestari Jaka Budiman ◽

Edison Edison

Keyword(s):

General Hospital ◽

Clinical Symptom ◽

Chronic Rhinosinusitis ◽

Nasal Obstruction ◽

Middle Turbinate ◽

Inferior Turbinate ◽

Septal Deviation ◽

Nasal Endoscopy ◽

Nasal Discharge ◽

Anterior Rhinoscopy

Abstrak Rinosinusitis kronik adalah inflamasi kronik pada mukosa hidung dan sinus paranasal yang sering terjadi, tetapi belum ada data mengenai profil pasien rinosinusitis kronik di RSUP Dr.M.Djamil Padang. Penelitian ini merupakan penelitian deskriptif dengan mengambil data rekam medis THT-KL RSUP Dr.M.Djamil periode 1 Januari – 31 Desember 2012 dengan metode total sampling. Terdapat 63 kasus rinosinusitis kronik di poliklinik THT-KL RSUP Dr.M.Djamil Padang periode 1 Januari – 31 Desember 2012. Kasus rinosinusitis kronik paling banyak terjadi pada kelompok usia 46 – 55 tahun (22,22%) dan banyak terjadi pada perempuan (60,32%). Berdasarkan tanda dan gejala yang ditemukan paling banyak adalah deviasi septum (41,27%). Gejala klinik paling banyak adalah hidung tersumbat (88,89%). Berdasarkan pemeriksaan rinoskopi anterior dan nasoendoskopi ditemukan kelainan pada kavum nasi, konka inferior, konka media, dan sekret. Disimpulkan bahwa rinosinusitis kronik banyak terjadi pada usia dewasa, jenis kelamin perempuan, tanda dan gejala yang ditemukan deviasi septum, gejala berupa hidung tersumbat, sertaditemukan kelainan berdasarkan pemeriksaan rinoskopi anterior dan nasoendoskopi.Kata kunci: rinosinusitis kronik, pemeriksaan rinoskopi anterior, pemeriksaan nasoendoskopi AbstractChronic rhinosinusitis is a common chronic inflammation of the nose and paranasal sinuses mucosa, but there is no data about profile of chronic rhinosinusitis patients at ENT clinic Dr.M.Djamil general hospital Padang. This research uses descriptive method by taking the data from the medical records at ENT clinic of Dr.M.Djamil general hospital during 1 January – 31 December 2012 with the method is total sampling. There are 63 chronic rhinosinusitis cases at ENT clinic Dr.M.Djamil Padang general hospital during 1 January – 31 December 2012. Most cases of chronic rhinosinusitis occurred in the age group 46 – 55 years old (22.22%) and higher in female (60.32%). The most sign and symptom finding is septal deviation (41.27%). The most clinical symptom is nasal obstruction (88.89%). Fromanterior rhinoscopy and nasoendoscopy examination, there are founded abnormalility of nasal cavity, inferior turbinate, middle turbinate, and nasal discharge. The conclusion is chronic rhinosinusitis often happened at adult ages, female, septal deviation as the most sign and symptom finding, nasal obstruction as the clinical symptom, and abnormal findings from anterior rhinoscopy and nasal endoscopy examination.Keywords: chronic rhinosinusitis, anterior rhinoscopy examination, nasal endoscopy examination

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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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Nasal Airway Obstruction: Prevalence and Anatomic Contributors

Ear Nose & Throat Journal ◽

10.1177/014556131809700615 ◽

2018 ◽

Vol 97 (6) ◽

pp. 173-176 ◽

Cited By ~ 12

Author(s):

David W. Clark ◽

Anthony G. Del Signore ◽

Roheen Raithatha ◽

Brent A. Senior

Keyword(s):

Airway Obstruction ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Septal Deviation ◽

Lateral Nasal Wall ◽

Nasal Airway ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

Nasal Valve Collapse ◽

Surgical Treatments

Surgical treatments for nasal airway obstruction (NAO) are commonly offered as part of otolaryngology practice. Anatomic causes include septal deviation, inferior turbinate hypertrophy, and nasal valve collapse (NVC). This study was performed to determine the prevalence of anatomic contributors to NAO. A total of 1,906 patients with sinonasal complaints were surveyed by 50 otolaryngologists in varying U.S. geographic regions. Patients were first evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) instrument to assess the NAO symptoms and their severity. Physicians then examined patients for the presence of the three anatomic contributors. Presence of septal deviation and turbinate hypertrophy was assessed through an internal nasal exam with direct or endoscopic visualization based on the physician's standard methodology for diagnosis. Presence of NVC was determined by the modified Cottle maneuver. Among all patients surveyed, prevalence was 67% for NVC, 76% for septal deviation, and 72% for inferior turbinate hypertrophy. We found that 64% of the patients (n = 1,211) had severe/extreme NOSE scores (≥55), representing the most likely nasal obstruction candidates for intervention. In these patients, the prevalence of NVC, septal deviation, and inferior turbinate hypertrophy was 73, 80, and 77%, respectively. Eighty-two percent of the 236 patients with severe/extreme NOSE scores who reported prior septoplasty and/or inferior turbinate reduction had NVC. Our study revealed a comparable prevalence of all three anatomic contributors across all patients and the subset with severe/extreme NOSE scores, highlighting the importance of evaluating the lateral nasal wall as a component of NAO treatment strategy.

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EVALUATING THE RESULTS OF SEPTOPLASTY AND PARTIAL INFERIOR TURBINOPLASTY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.4.6 ◽

2017 ◽

pp. 46-52

Author(s):

Thanh Thai Le ◽

Phuong Nam Tran ◽

Thi Ngan An Nguyen

Keyword(s):

Key Words ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Grade Ii ◽

The Common

Aims: To study outcomes of septoplasty and partial inferior turbinectomy (PIT) method, expecting leastsurgical equipment, good result, price rationalization. Methods: Prospective, cross-sectional study. Including 40 patients treated by septoplasty and PIT method. Assessment had been made after 3 months post-op. Results: The common symptoms were nasal obstruction (100%), headache (40%). The deformities of nasal septalwere deviation (42.5%), crest (30%). There were 67.5% of patients with severe bilateral hypertrophic inferior turbinate, mostly over grade II, enlargement both soft and bone parts (60%). After 3 months, the nasal obstruction and headache presented good or great results in 90% of patients, 93.7% of patients had straight nasal septaland 90% hadsmall inferior turbinate.VAS: patients’s contentment was 100%. Conclusions: The study showed that septoplasty and partial inferior turbinectomy presented good results with 87.5% after surgery and 90% after 3 months. Key words: septal deformity, hypertrophy inferior turbinate, septoplasty, partial inferior turbinectomy

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Bioabsorbable Implant for Treatment of Nasal Valve Collapse with or without Concomitant Procedures

Facial Plastic Surgery ◽

10.1055/s-0041-1726464 ◽

2021 ◽

Author(s):

Douglas M. Sidle ◽

Pablo Stolovitzky ◽

Ellen M. O'Malley ◽

Randall A. Ow ◽

Nathan E. Nachlas ◽

...

Keyword(s):

Adverse Events ◽

Nasal Obstruction ◽

Large Population ◽

Inferior Turbinate ◽

Nasal Valve ◽

Serious Adverse Events ◽

Vas Scores ◽

Nasal Implant ◽

Nasal Valve Collapse

AbstractThe aim of the study is to report outcomes after treatment of nasal valve collapse with a bioabsorbable nasal implant. It involves two prospective, multicenter, post-market studies evaluating long-term effectiveness of the LATERA implant for severe to extreme nasal obstruction. Participants underwent implant alone or with concomitant inferior turbinate reduction (ITR) and/or septoplasty. Outcome measures included the change from baseline Nasal Obstruction Symptom Evaluation (NOSE) scores, NOSE responder rates, visual analog scale (VAS) scores, and adverse events. A total cohort of 277 participants (109 implants only, 67 implants + ITR, 101 implants + septoplasty + ITR) enrolled at 19 U.S. centers was available for analysis with 177 participants (69 implants only, 39 implants + ITR, 69 implants + septoplasty + ITR) available at 2 years. The mean changes from baseline in NOSE scores and VAS scores were statistically significant (p < 0.001) at all follow-up periods. The baseline NOSE score of 77.8 ± 13.6 was improved to 24.2 ± 23.6 at 24 months. Greater than 90% of participants were NOSE responders across all follow-up periods, 6.1% withdrew for lack of treatment effect. The baseline VAS score of 66.7 ± 18.8 was improved to 21.1 ± 23.9 at 24 months. There were no serious adverse events related to the device or implant procedure. Implant retrieval rate was 4.0% (22/543 implants). Nonserious adverse events were mild to moderate in severity, typically occurred within 6 months of implant, and resolved or were stable. Significant reductions in NOSE and VAS scores and high responder rates from our large population of patients with nasal obstruction who had nasal valve implants confirm sustained effectiveness at 24 months after treatment. The studies are registered on www.clinicaltrials.gov (NCT02952313 and NCT02964312).

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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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Nasal Cytology in Radiofrequency Turbinate Volume Reduction

ORL ◽

10.1159/000513629 ◽

2021 ◽

pp. 1-6

Author(s):

Giancarlo Pecorari ◽

Giuseppe Riva ◽

Claudia Bartoli ◽

Mattia Ravera ◽

Valeria Dell’Era ◽

...

Keyword(s):

Allergic Rhinitis ◽

Effective Treatment ◽

Nasal Obstruction ◽

Nasal Mucosa ◽

Inferior Turbinate ◽

Volume Reduction ◽

Nonallergic Rhinitis ◽

Turbinate Hypertrophy ◽

Nasal Cytology ◽

Rhinitis Medicamentosa

Introduction: Radiofrequency turbinate volume reduction (RFTVR) is an effective treatment of inferior turbinate hypertrophy. RFTVR can reduce epithelial cell alterations in nasal mucosa. The aim of this observational study was to evaluate the effects of RFTVR on nasal obstruction and cytology, stratifying for different types of rhinitis. Methods: Nasal cytology and subjective nasal obstruction were evaluated on 113 patients before RFTVR (T0) and after 3 months (T1). The patients were divided into groups on the basis of the underlying disease: allergic rhinitis, nonallergic rhinitis, rhinitis medicamentosa, and other diseases (e.g., hormonal-based turbinate hypertrophy). Results: Nasal cytology at T0 identified 42 patients with allergic rhinitis, 40 with nonallergic rhinitis, 19 with rhinitis medicamentosa, and 12 with other diseases. An improvement of nasal cytology at T1 was observed in 29.2% of cases. They mainly consisted of patients with nonallergic rhinitis with neutrophils, whose neutrophil infiltrate decreased. Only 2 cases (1.7%) showed a worsening of nasal cytology at T1. A statistically significant decrease in subjective nasal obstruction was observed for every group (p < 0.05). Higher differences of nasal obstruction between T0 and T1 were found in patients with rhinitis medicamentosa or other diseases. Conclusion: RFTVR represents a safe and effective treatment for turbinate hypertrophy of various etiology. It is not responsible for a worsening of inflammatory infiltrate of the nasal mucosa.

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