Inferior Turbinate Hypertrophy Research Articles

Surgical treatment of rhinogenic contact point headache

Aim The aim of the study was to search for the role of correction of abnormalities of the nasal cavity in rhinogenic contact point headache and to evaluate its role in the treatment of this type of headache. Patients and methods The study included 20 patients who were recruited from September 2016 till December 2016 with rhinogenic contact headache of more than 1-year duration. Evaluation of surgical management for these cases was done as regards improvement of headache duration, intensity, and frequency over a follow-up period of 3 months at least after the operation. Results In all, 20 patients were included with ages in the range from 19 to 45 years; 11 of them were men and nine were women. Sixteen cases showed complete cure, two showed improvement, and two showed unsatisfied results. Deviated septum was found in 17 (85%) cases, concha bullosa in seven (35%) patients, and hypertrophied inferior turbinate in six (30%) patients. More than one anatomical variation was encountered in most of the cases. The two failed cases showed preoperative long duration since they started to complain of headache and longer duration of each headache attack. Conclusion Intranasal anatomical variations play a role in the pathogenesis of contact rhinogenic headache and the surgical treatment of these anatomical variations helped in improving contact headache.

Extracorporeal Septoplasty-A Well Proven Technique for Treatment of Crooked Noses.

Crooked noses (noses with complex septal and pyramidal deviations) are an important challenge for both plastic surgeons and otolaryngologists. Extracorporeal septoplasty, described by Gubisch constitutes an effective solution to this problem. The article describes a series of 7 cases (5 males and 2 females) in which this method was used during open rhinoseptoplasty. The technique we used is described in detail. All the patients showed improvement of the nose appearance and good nasal air flow. Hypertrophy of the right inferior turbinate complicated one case, but was resolved with electro cauterization. Although the learning curve is slow and it claims the surgeon’s imagination, the method is sometimes the only solution in complex cases of septal deviation. Our short series demonstrates that good indication and careful dissection are prerequisites for success in difficult cases.

Effect of Endoscopic Correction on the Blood Pressure of Hypertensive Patients with Deviated Nasal Septum Symptoms

Introduction: The objective of the study is to evaluate the effect of endoscopic correction of septum on blood pressure in patients with deviated nasal septum symptoms and to assess positive changes occur between deviated nasal septum and hypertension. Materials & Methods: The study was conducted at various hospitals in the department of ENT, Madinah Munawarah, Saudi Arabia. Hundred adults, aged 20-45 years, with symptomatic nasal septal deviation, newly detected untreated hypertension (mean BP 140/90 mmHg), undergoing septoplasty operation and sub mucosal diathermy of hypertrophied inferior turbinate (when present), were included. Postoperative follow up for ENT examination and BP measurement was done at 1, 6 and at the end of year. Results: There are 68 patients were taken for this study from various hospitals in the department of ENT, Madinah Munawarah region, Saudi Arabia. Among 68 patients 42 Male and 26 Female patients at the mean age of 35.23±2.15 years with range of 29 to 44 with respective of male and female. Age distributed in group as 19% of patients were in 25-30, 43% of patients in 31-35, 22% of patients in 36- 40, and 16% of patients were in 41-45, major fall in age group of 31-35 years. Conclusion: In our study we conclude that control of blood pressure in patients with nasal septal deviation can be achieved by surgical correction effectively and safely. Consequently patients with symptomatic septal deviation should be assured of prevention of secondary cardiovascular problems due to high blood pressure.

Role of CT Nose Paranasal Sinuses and Nasal Endoscopy for Decision Making in a Case of Deviated Nasal Septum

Introduction
 Deviated nasal septum (DNS) can be asymptomatic in an individual or may cause nasal obstruction. The condition is generally diagnosed clinically and based on clinical diagnosis it is managed Surgically by large without much heed to diagnostic procedure. Thus, often underlying other causes of Obstruction is missed. Thus, it becomes essential to evaluate every patient presenting with history of Nasal obstruction and clinically Deviated septum, with aid of Nasal Endoscopy and CT scan Nose Paranasal Sinuses (PNS) to rule out/diagnose other coexisting conditions.
 Methods and Methodology
 100 patients who presented with nasal obstruction and clinically diagnosed to have Deviated Nasal Septum were then subjected to Nasal Endoscopy and CT scan Nose and PNS and findings were noted for analysis.
 Results and Analysis
 Of these 100 patients, 48 patients were found to have coexisting pathological conditions/anatomical variants. Various anatomical and pathological Conditions were found to coexist together. Inferior turbinate hypertrophy in 34% is the most common pathological condition found to be associated with DNS followed by of sinusitis in 25% patients apart from polyp, concha bullosa and paradoxical middle turbinate.
 Discussion
 Studies done so far shows there is a definite link of deviated nasal septum to various anatomical and pathological conditions of the nose. CT Scan Nose PNS and Nasal Endoscopy plays a vital role in diagnosing such anomalies.
 Conclusion
 Most of the patients, presenting with nasal obstruction and having Deviated Nasal Septum, undergo management without proper analysis and returns with recurrence of symptoms which could be analyzed properly if Nasal endoscopy and CT scan is employed during diagnosis of the condition, reducing risk of treatment failure.

A comparative study of conventional septoplasty versus endoscopic septoplasty

Introduction:A deviated septum can be asymptomatic or can cause functional and cosmetic abnormalities. Different studies have been proposed for the correction of deviated septum, but septoplasty has been the treatment of choice. Septoplasty is a more conservative surgery and endoscopic septoplasty has become increasingly popular over the past few decades.Materials and Methods:The study was carried out to compare the post-operative results among patients of conventional and endoscopic septoplasty and to assess the efficacy of endoscopic septoplasty with other surgeries. The present study was conducted among 40 patients of deviated nasal septum admitted in the Department of Otolaryngology of Adesh Institute of Medical Sciences and Research, Bathinda. Patients were selected by simple random sampling and were divided into Groups A and B, with 20 patients in each group. Group A underwent conventional septoplasty and Group B underwent endoscopic septoplasty.Results:The male-to-female ratio in the present study was 3:1. Deviated nasal septum was commonly associated with inferior turbinate hypertrophy (45%) and concha bullosa (27.5%). Postoperatively, a significant relief from the symptoms of nasal obstruction (85%), nasal discharge (25%), headache (30%), and postnasal drip (55%) was observed in endoscopic septoplasty. Complication rate was higher in conventional septoplasty. The endoscopic approach facilitates proper alignment by limited and precise resection of pathological areas.Conclusion:Endoscopic septoplasty provides precise resection of the pathological areas and better illumination with limited flap dissection and exposure.

Computed Tomographic Findings of Nasal and Paranasal Sinuses in Patients Scheduled for Rhinoplasty in Shahid Mostafa Khomeini Hospital during 2011-13

Objective: Rhinoplasty is done to improve the morphology of the nose whilst also restoring its physiological function. Currently it is possible to perform rhinoplasty and endoscopic sinus surgery simultaneously. The need has therefore arisen to evaluate anatomical variation within the nose and paranasal sinuses in symptom-free patients who are scheduled for rhinoplasty. Coronal computed tomography (CT) is the standard method used to evaluate the nose and paranasal sinuses. We aimed to evaluate the frequency of anatomical variation noted within the nose and paranasal sinuses on coronal CT in patients scheduled for rhinoplasty. Methods: This is a descriptive, cross-sectional, retrospective study of CT findings in 84 patients who underwent rhinoplasty at Mostafa Khomeini Hospital, Shahed University, Tehran between 2011-13. The CT findings were evaluated in three different predefined categories: nasal septal, nasal turbinate, and paranasal sinuses abnormalities. Results: The study involved 84 individuals, consisting of 26 men and 58 women. The most frequent findings in the nasal septum category were nasal septal deviation (69.04%) and nasal septal spur (33.33%), whereas concha bullosa (45.23%) and inferior turbinate hypertrophy were the most frequent abnormality in the nasal turbinates category. Mucosal thickening of the sinuses (45.23%) and partial opacification of the sinuses (21.42%) were the most common findings in the paranasal sinuses. Conclusion: The high frequency of anatomical variation, inflammatory and congenital abnormal findings in CT images of the paranasal sinuses in patients scheduled for rhinoplasty indicates that preoperative CT examination may be useful in avoiding multiple surgical operations and in reducing costs.

HUMAN BETA-DEFENSIN-3 GENE EXPRESSION IN THE NASAL AND SINONASAL MUCOSA

Sensitive receptors of the olfactory sensory system are located in the nasal cavity mucosa. The aim of this study was to evaluate the human beta-defensin-3 (hBD-3) gene expression in the surface epithelium of the nasal and sinonasal mucosa. Surgical samples from patients with nasal and sinonasal disease (n = 85) (sinus maxillaries mucosa, choana polyps, middle nasal passage polyps, sinus maxillaries polyps, inferior turbinate mucosa of hypertrophic rhinitis, inferior turbinate mucosa and the middle nasal passage mucosa as controls) were investigated. Total RNA was extracted and analysed by real-time RT-PCR for hBD-3 as well as beta-actin mRNA.hBD-3 gene expression was detected in all examined anatomical regions in 14.29-33.33% samples at low levels, but it was absent in the hypertrophic inferior turbinate mucosa (Fisher’s exact test, p < 0.05 compared to the middle nasal passage mucosa; p < 0.01, odds ratio (OR) 31.15, 95% confidence interval (CI) 1.53÷633.6 compared to the middle nasal passage polyps). The highest hBD-3 mRNA expression detection frequency was detected in the middle nasal passage polyps (53.84% cases) (p < 0.05, OR 7.00, CI 1.10÷44.63 compared to the sinus maxillaries mucosa). The highest levels of hBD-3 gene expression was detected in the middle nasal passage polyps also (Wilcoxon signed rank test, p < 0.05 compared to the hypertrophic inferior turbinate mucosa). Clinically, inflammatory polyps are found in the middle turbinate in patients with chronic rhinosinusitis but not in the inferior turbinate. In the context of chronic inflammation, apart from direct antimicrobial activity, high concentrations hBD-3 also potentially contributes to epithelial injury and fibrotic remodeling.

Prevalence of Anatomical Abnormalities of Nose & Paranasal Sinuses in Cases of Rhinogenic Headache Among Sohag University Students

AbstractObjective: to determine the prevalence of anatomical abnormalities of nose and PNS in cases suffering from rhinogenic headache among Sohag University students seeking health services in the ENT outpatient clinic of the Student Hospital in Sohag University along the period starting Oct. 2017 till June 2019. Study design: Across sectional studyResults: 104 students -(59.6 %) females- were enrolled in the study, inhabiting rural and/or slum areas of Sohag (69.2 %). They had a narrow range of ages; 19 – 23 years; X` = 20.13 ± 1.25 years. Frontal site of headache predominated, then the nasal site. These followed by periorbital, tempo parietal, temporal and scalp regions respectively in 32.7, 25, 17.3, 11.5, 7.7 and 5.8 % of the rhinogenic cases. Each attack lasted 3.27± 1.76 days duration with maximum 7 days. Prevalence of rhinogenic headache due to anatomical abnormalities was (26.9 %). over the frontal, glabellar and periorbital regions. A highly significant statistical difference between cases of rhinogenic headache with anatomical abnormalities and those without anatomical abnormalities (p = .004) regarding how the headache was presented; Heaviness (16.2 %), pressure (81 %) and dullness (2.7 %) were the type of such headache. It was found that most of the cases have combined abnormalities.DNS affected 16 cases (43.2 %), a manifestation of concha bellosa in 9 cases(24.3%), bilateral inferior turbinate hypertrophy appeared in 10 cases(27%) . Haller cells was detected in about ( 1.9 % )of the anatomical abnormalities also.

Comparing the Effect of SubMucosal Resection With Electrocautery Method for the Treatment of Inferior Turbinate Hypertrophy at Amir Kabir Hospital in Arak City

Comparing the Effect of SubMucosal Resection With Electrocautery Method for the Treatment of Inferior Turbinate Hypertrophy at Amir Kabir Hospital in Arak City

An optimization method for surgical reduction of hypertrophied inferior turbinate

Surgical reductions of the hypertrophied inferior turbinate (HIT) can improve nasal obstruction. However, there is currently a lack of personalized and objective methods to guide surgical operations, which results in the excessive or inadequate resection of HIT. In this study, we proposed an optimizing method based on homotopy deformation to determine the resected amount and shape of the tissue by matching the flow resistance in the two nasal passageways. The simulation results obtained using computational fluid dynamics showed that after such an optimization procedure, the most obstructed nasal side could have a similar air flux as the less obstructed side. A 35% and a 56% less tissue resection in the optimizing operation compared to that in the total turbinectomy could well balance the air flow between the two nasal cavities in the simulations for patients 1 and 2 with unilateral nasal obstruction respectively. Compared with the optimization operation, the total turbinectomy made a more aggressive resection of HIT, which could worsen the air conditioning capacity of the nose. A sensitivity test indicated that in the optimization operation, the most constricted region in the nasal cavity should be adequately enlarged. However, more tissue resection than is required for the optimization operation did not improve the flow in the obstructed side strikingly. Simulations of the optimization operation in both nasal cavities for a patient with bilateral nasal obstruction were also performed. The flow rate could reach the normal level and be well balanced in the two sides after such an optimization procedure.

The Role of Nasal Endoscopy in the Management of Rhinosinogenic Headache.

Nasal endoscopy is one of the common out-patient diagnostic procedures in ENT practice. Patients suffering from persistent rhinosinogenic headache which is not responding to standard medical management demand a thorough evaluation that incorporates diagnostic nasal endoscopy (DNE). Rhinosinogenic headache is multifactorial which includes contact point, deviated nasal septum, inferior turbinate hypertrophy, nasal polyposis and sinusitis. To identify the particular cause of the headache is necessary for appropriate management. We conducted a prospective observational study to assess the role of nasal endocopy in diagnosis and management of rhinosinogenic headache persisting for at least 3months, over a period of one and half year. Thirty patients fulfilling the inclusion criteria were enrolled in the study. We categorized the headache as mild, moderate and severe. After DNE, we found that 93.33% (n = 28) had deviated nasal septum (DNS), 40% (n = 12) had septal spur, 10% (n = 3) had polyp, 50% (n = 15) had contact point, 67% (n = 20) had inferior turbinate hypertrophy (ITH), 26.67% (n = 8) had pneumatised middle turbinate or concha bullosa and 50% (n = 15) patients of sinusitis. After computed tomographic evaluation, 30% (n = 9) patients underwent septoplasty, 20% (n = 6) underwent endoseptoplasty, 40% (n = 12) underwent middle turbinate lateralisation (MTL), 16.67% (n = 5) underwent FESS, 30% (n = 9) underwent FESS with endoseptoplasty, 3.33% (n = 1) Caldwell Luc's operation for unilateral maxillary polyp with sinusitis. Postoperatively we found that, 86.67% (n = 26) had total relief, 6.67% (n = 2) had partial improvement and 6.67% (n = 2) had no improvement of headache. Our study demonstrates that nasal endoscopy has significant role in diagnosis and management of rhinosinogenic headache.

Comparison of Radiofrequency and Microdebrider-Assisted Turbinoplasty for Treatment of Isolated Inferior Turbinate Hypertrophy

Comparison of Radiofrequency and Microdebrider-Assisted Turbinoplasty for Treatment of Isolated Inferior Turbinate Hypertrophy

Investigating the effects of inferior turbinate outfracture on the lacrimal system by evaluating the results of paranasal sinus computed tomography and nasolacrimal irrigation test.

This study aims to investigate the effects of inferior turbinate outfracture on the nasolacrimal system and tear flow. Forty-seven patients (26 males, 21 females) between the ages 18 and 52years (mean age-29.0 ± 9.6years) were included in the study. Preoperative nasal examinations and paranasal sinus computed tomography of the patients were carried out; the direction, location, nasal septum deviation classification and inferior turbinate hypertrophy size classification were evaluated. Lacrimal irrigation test was performed preoperatively and 14days postoperatively. The study included 47 patients who underwent septoplasty and inferior turbinate outfracture. The mean duration of lacrimal irrigation test was 2.9 ± 0.8s on the right side and 3.0 ± 1.1s on the left side preoperatively, and 2.1 ± 0.8s on the right side and 2.2 ± 1.0s on the left side postoperatively. No significant relationship between direction, location classification, angle nasal septum deviation classification and lacrimal irrigation test duration was found. A significant relationship between size classification of the left inferior turbinate and preoperative lacrimal irrigation test duration was noted (p = 0.030). Moreover, a significant decrease between preoperative and postoperative lacrimal irrigation test duration after inferior turbinate outfracture (p = 0.000) was noted. We concluded that outfracture of the inferior turbinate with septoplasty surgery may benefit the regulation of tear flow. In addition, we concluded that lacrimal irrigation test duration may be effective in determining the patients with subclinical nasolacrimal duct partial obstruction due to inferior turbinate pathologies.

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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. </p><p class="abstract"><strong>Results:</strong> 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).</p><p class="abstract"><strong>Conclusions:</strong> 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. </p>

Role of endoscopy in rhinogenic contact headache not responding to medical treatment

ObjectiveTo assess the role of various anatomical variation of the nose in the pathogenesis of contact point rhinogenic headache of noninfective or organic cause and to evaluate the role of endoscopic surgery with removal or correction of the anatomical variation that caused headache in the management.Patients and methodsThis study included 30 patients with refractory or resistant headache for more than 1 year and diagnosed to have sinonasal anatomical variations. They were presented to the outpatient clinics of Al-Zahraa University Hospital in the period from May 2015 to May 2018. There ages ranged from 18 to 34 years. A total of 20 (66.7%) patients were males and 10 (33.3%) were females. Data from this group were analyzed retrospectively.ResultsMultiple anatomical variations were noted by endoscopy and computed tomographic scans in 30 patients. These variations included septum deviation in 30 (100%) patients followed by hypertrophied inferior turbinate in 15 (50%) patients then concha bullosa in 14 (46.7%) patients. In these 30 patients, 25 (83.3%) cases showed complete cure, three (10%) cases showed improvement, whereas two (6.7%) cases were unsatisfied.ConclusionMinor intranasal anatomical variations or hidden infection may be the cause of primary headache misdiagnosed as a headache of unknown etiology. The functional endoscopic sinus surgery had succeeded in eliminating or significantly reducing headache attacks.

Major Structural Airway Pathologies of Patient Complaining Nasal Obstruction: Analysis of Frequency, Preoperative Complaints and Benefit from Surgery.

Modern rhinoplasty has an aesthetic and a functional component that cannot be separated. Functional rhinoplasty generally concentrates on optimizing nasal airflow. Numerous techniques have been described for correction of each pathology. There seems to be a consensus on the benefit of surgery to patients with nasal obstruction. Present study aimed to determine if specific airway pathologies have differential effects on patient complaints and techniques addressing them have differential effects on perceived benefit from surgery. The records of 300 patients complaining nasal obstruction and had computerized tomography (CT) between April 2015 and April 2018 were retrospectively reviewed. Based on surgical notes, surgical techniques used for each patient were recorded. A survey using Nasal Obstruction Symptom Evaluation (NOSE) scale is done by phone. After descriptive statistics, preoperative complaint-diagnosed pathology, and postoperative relief-treated pathology relationships were evaluated. Preoperative and postoperative NOSE scores showed statistically significant difference (P <0.001). The CT analysis showed that septal deviation rate among patients complaining nasal obstruction is 85%, internal valve insufficiency rate is 34.4%, mild and severe inferior turbinate hypertrophy was 71% and 6%, respectively. Bullous and total concha bullosa of middle turbinate was 17.3%. Nearly 90% of patients had 2 or more types of pathology in CT analysis. Preoperative and postoperative NOSE scores showed no statistically significant relationship with singular intranasal pathologies and techniques used for correcting them, respectively. Despite general fall in NOSE scores in the whole study group, treatment of a specific pathology does not change NOSE score more than a patient who already does not have the pathology. None of the pathologies or treatments addressing them have a dominating effect on preoperative complaints or obtained relief after the surgery. So, success of functional rhinoplasty cannot rely on correction of a specific pathology. A comprehensive analysis and correction of every pathology is paramount.

Predictive fiberoptic endoscopic findings of upper airway in children with allergic rhinitis

ObjectiveTo determine predictive fiberoptic findings of upper airway in children with allergic rhinitis. Method129 children had fiberoptic evaluation of nasal cavity, pharynx and larynx. They were divided into allergic rhinitis group and normal group based on skin prick test results. All video recordings were randomly reviewed by three independent national board-certified otolaryngologists who were blinded to the clinical details and outcomes of the participants’ allergy testing. Each physician assessed and documented 10-item questionnaire. Intra-rater, inter-rater reliability and correlation between items and allergic status was calculated. ResultsIntra-rater reliability was moderate to perfect for all physicians on all items (kappa = 0.578–0.962). Inferior turbinate hypertrophy (κ = 0.714, p = 0.02), middle turbinate hypertrophy (κ = 0.728, p = 0.01), discoloration of inferior turbinate (κ = 0.685, p = 0.01), adenoid hypertrophy (κ = 0.662, p = 0.02) had good inter-rater reliability and these findings were predictive of allergic rhinitis. Adenoid hypertrophy was less encountered in allergic rhinitis. All other endoscopic findings beyond the nasal cavity were not predictive for allergic rhinitis in children. ConclusionNasal cavity findings including inferior turbinate hypertrophy, middle turbinate hypertrophy, discoloration of inferior turbinate and adenoid tissue assessment rather than pharyngolaryngeal findings are predictive of allergic rhinitis in children.

Endoscopic Assisted Septoplasty Versus Conventional Septoplasty;a Prospective Study

Background and objectives: Correction of deviated nasal septum underwent many modifications. Traditionally, it has been performed by using a headlight and nasal speculum and recently, endoscopic techniques have been used for septal surgery. As a consequence, the present study aimed to compare the efficacy of conventional and endoscopic septoplasty in treating septal deformity. Methods:the study was conducted on fifty patients planned for septoplasty; they were randomly selected and divided into two groups; Group I undertaken conventional septoplasty and Group II via endoscopic septoplasty with twenty-five patients in each group. Postoperative symptom analysis and complications with objective anatomical evaluation by endoscopic examination were explained in this study. Results: Septal deviation was commoner in males than females in a ratio of 1.4: 1. Age ranged from 18 to 58 years with mean age ± SD (stand- ard deviation) 33.42± 10.42. Nasal septum deformity commonly associated with inferior turbinate hypertrophy (76%), concha bullosa (24%) and mucosal disease (26%). Postoperatively, subjective assessment of relieving symptoms was noticed in endoscopic septoplasty including nasal obstruction (96%), nasal discharge (88%), post nasal drip (92%) and headache (80%). Endoscopic septoplasty was superior in correction of posterior deflections in comparison to conven- tional technique while there was no significant difference regarding anterior deviations. Eventually lesser complication rates were observed in endoscopic technique. Conclusions: Endoscopic septoplasty is a viable alternative method for correcting septal deviation, and is more effective in relieving symptoms. It can be performed in conjunction with endoscopic sinus surgery.

A Prospective Study to Compare the Efficacy of Powered Turbinectomy Versus Submucous Resection in the Surgical Management of Inferior Turbinate Hypertrophy.

Over the years many surgical techniques have been described in the literature for the treatment of inferior turbinate hypertrophy (ITH) but the debate for ideal procedure is still on. In our study we are comparing two surgical procedures namely submucosal resection (SMR) of inferior turbinate and Powered inferior turbinectomy (PT) for the management of ITH. Surgical procedures are to be analyzed in terms of results and complications by subjective and Objective assessment. A prospective study was conducted from 1st December 2011 to 1st June 2013. Subjective assessment of nasal obstruction was done by visual analogue scoring before surgery and graded into none, mild, moderate, and severe. Patients were also subjected to nasal endoscopy for objective assessment of inferior turbinate size and graded as I, II, III. A total of 60 patients were operated (30 patients in each group), patients in Group A underwent SMR and in Group B patients PT was performed. Patients were assessed for various parameters like age, gender, laterality, intra operative and postoperative complications. Overall improvement of 66.7% in Nasal Obstruction and 76.7% in size of inferior turbinate was seen in Group A, whereas improvement of 90% in nasal Obstruction and 83.3% in size of turbinate was seen in Group B. Both SMR and PT are efficient methods for relieving nasal obstruction related to ITH. However, the results in our study confirm that PT is a safe and effective procedure in relieving nasal obstruction and enabling optimal volume reduction with preservation of function of the inferior turbinate.

Safety and efficacy of extraturbinal microdebrider-assisted inferior turbinoplasty in children

BackgroundNasal obstruction is commonly seen in children and can be caused by a variety of factors. Turbinate hypertrophy has become a more frequent entity in pediatric patients presenting with nasal obstruction.AimThis study aims to assess the effectiveness and safety of extraturbinal microdebrider-assisted inferior turbinoplasty (MAIT) in relieving inferior turbinate hypertrophy in children.Patients and methodsThis prospective study was conducted from May 2016 to May 2017 in a tertiary referral hospital. Fifty pediatric patients with chronic hypertrophic rhinitis were enrolled in the study. We tried the extraturbinal MAIT technique to reduce inferior turbinate size. The degree of nasal obstruction was assessed using subjective, clinical symptom grading tools, visual analogue scale, and saccharin clearance test at 1 and 6 months postoperatively. Any postoperative complications were also noted.ResultsMean age of patients were 12.7±9.5 years (range: 6–18 years). Significant postoperative improvement (P<0.001) was noted in the degree of nasal obstruction in 1 month and was maintained after a follow-up period of 6 months. Majority of patients had minimal crusting with good tissue healing with no adhesions or atrophic changes and with significant improvement of saccharin clearance time at 6 months postoperatively.ConclusionExtraturbinal MAIT is an effective and safe procedure in children compared with other reported procedures.