The Long-term Effect of Inferior Turbinate Surgery Techniques on Nasal Obstruction and Quality of Life.

Teemu Harju,Jura Numminen

doi:10.1177/00034894211049573

Abstract

Objective:The aim of the study was to compare the long-term effects of radiofrequency ablation (RFA), microdebrider-assisted inferior turbinoplasty (MAIT), and diode laser techniques on the severity of nasal obstruction and quality of life (QOL) in a 3-year follow-up.Methods:The patients filled a Visual Analog Scale (VAS) regarding the severity of nasal obstruction and the Glasgow Health Status Inventory (GHSI) questionnaire preoperatively and during the control visits at 3 months and 3 years. Acoustic rhinometry was also performed. A total of 78 patients attended both control visits.Results:All 3 techniques improved the VAS score for the severity of nasal obstruction and the GHSI total score significantly compared to the preoperative values at both 3 months and 3 years. Compared to the preoperative values, all 3 techniques increased the V2 to 5 cm values significantly at 3 months. After 3 years, compared to the preoperative values, the MAIT (P = .005) and diode laser (P < .001) still had a statistically significant volume increase in V2 to 5 cm, whereas the RFA (P = .06) did not achieve a statistically significant effect.Conclusion:The RFA, MAIT, and diode laser all improved both the patients’ subjective sensation of the severity of nasal obstruction and QOL significantly. The response was sustained during the 3-year follow-up period with all 3 techniques. A weakening in the objective treatment response to RFA was found in the longer follow-up, but that did not cause a weakening of the patients’ subjective treatment response.

Highlights

Chronic nasal obstruction is a common nasal symptom that has many adverse effects, including mouth breathing, dryness of the oropharynx, nasal speech, disordered sleep, restlessness, malaise, reduced lung volume, and overall reduced quality of life (QOL)
Compared to the preoperative values, all 3 techniques improved the Visual Analog Scale (VAS) score for the severity of nasal obstruction both at 3 months and 3 years (P < .001 with all techniques), and there were no significant differences in the VAS score changes between the groups (Table 3)
All 3 examined techniques improved the Glasgow Health Status Inventory (GHSI) total score compared to the preoperative values both at 3 months and 3 years (P < .001 with all techniques), and there were no significant differences in the GHSI total score changes between the groups (Table 4)

Summary

Introduction

Chronic nasal obstruction is a common nasal symptom that has many adverse effects, including mouth breathing, dryness of the oropharynx, nasal speech, disordered sleep, restlessness, malaise, reduced lung volume, and overall reduced quality of life (QOL). The long-standing swelling of the submucosal tissue may become irreversible, leading to inferior turbinate enlargement, which is one of the main causes of chronic nasal obstruction.[1] Conservative treatment of inferior turbinate enlargement is based on intranasal corticosteroids.[2] If the topical treatment fails, inferior turbinate surgery can be considered.[3,4]. Inferior turbinate procedures have concentrated on aiming at the reduction of the turbinate, with an improvement in nasal obstruction while maintaining nasal function and minimizing complications.[5] In most of the cases, surgical treatment is targeted at the medial and inferior submucosal layer of the inferior turbinate.[6] Various surgical techniques have been described for the reduction of enlarged inferior turbinates. Of the several available laser techniques, diode laser treatment has gained popularity.[7]

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Conclusion