Inferior Turbinate Hypertrophy Research Articles

Role of Bilateral Inferior Turbinoplasty as an Adjunct to Septoplasty in Improving Nasal Obstruction and Subjective Performance in Patients With Deviated Nasal Septum Associated With Allergic Rhinitis: An Interventional, Prospective Study.

Patients with nasal obstruction due to deviated nasal septum (DNS) often have allergic rhinitis (AR) as contributing factor. When optimal medical therapy for AR fails, septoplasty alone may not adequately treat nasal obstruction. Therefore, with bilateral inferior turbinate hypertrophy representing long-standing AR, adding bilateral inferior turbinoplasty (BIT) to septoplasty might be beneficial. To assess whether septoplasty with/without BIT alleviates nasal obstruction in the above patient cohort and whether adding BIT to septoplasty brings significant benefit. In this interventional, prospective study, patients with nasal obstruction due to DNS and persistent, moderate-severe AR refractory to optimal medication were randomly allocated into group A (septoplasty alone) and group B (septoplasty with BIT). Nasal Obstruction and Symptom Evaluation (NOSE) score, along with Subjective Performance parameters (days-off/month; number of outdoor visits/month; overall satisfaction score [OSS]) were used to assess the symptom and quality of life, respectively, at follow-up. Each group had 40 age/sex-matched patients. Friedman test, and subsequent pair-wise comparison within groups without Bonferroni correction, revealed that septoplasty with/without BIT elicited significant reduction in NOSE scores and in the Subjective Performance parameters (days-off/month; number of outdoor visits/month) at 3 and 6 months. Wilcoxon Signed Rank test revealed that the OSS within groups also improved significantly with time. Further, comparison between groups revealed significant improvement in NOSE scores at all levels of follow-up when BIT was included. However, there were no significant differences between groups in the Subjective Performance parameters at any level of follow-up. Improvement in OSS between groups was significant only at 3 months but not subsequently. Septoplasty with/without BIT is helpful in treating patients with DNS and refractory AR. However, although adding BIT brings significant benefit in decreasing nasal obstruction, it does not significantly improve the Subjective Performance parameters during follow-up, except for OSS at the third month.

Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study

BackgroundIn individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT).MethodsThe CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined.ResultsA significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD.ConclusionThe results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.

Development of High-Intensity Focused Ultrasound Therapy for Inferior Turbinate Hypertrophy.

ObjectivesInferior turbinate (IT) hypertrophy is the main cause of chronic nasal obstruction. We developed a high-intensity focused ultrasound (HIFU) ablation device to treat patients with IT hypertrophy.MethodsFirst, computed tomography images of patients with no evidence of sinonasal disease were evaluated to measure and compare the IT, medial mucosal thickness (MT), and space between the nasal septum and IT according to clinical characteristics such as septal deviation. A HIFU prototype was developed based on the above human anatomical studies. The experimental study was performed in five pigs; the nasal volume and histological changes at 1 and 4 weeks postoperatively were evaluated to compare the efficacy of HIFU turbinoplasty with that of radiofrequency turbinoplasty and a control group.ResultsThe mean medial MT of the anterior, middle, and posterior portions of the IT were 4.66±1.14, 4.23±0.97, and 6.17±1.29 mm, respectively. The mean medial space was 2.65±0.79 mm. The diameter and focal depth of the prototype were 4 mm and 3 mm, respectively. HIFU showed no postoperative complications, including bleeding or scar formation. After HIFU treatment, the nasal volume increased by 196.62 mm3 (7.8%) and 193.74 mm3 (8.3%) at 1 week and 4 weeks, compared with the increase of 87.20 mm3 (3.1%) and 213.81 mm3 (9.0%), respectively,after radiofrequency therapy. A qualitative histological analysis after radiofrequency turbinoplasty showed epithelial layer disruption at 1 week and increased fibrosis, along with decreased glandular structure, at 4 weeks. The HIFU group had an intact epithelial layer at 1 week postoperatively. However, significant differences were observed at 4 weeks, including increased fibrosis and decreased glandular structure.ConclusionThe efficacy and safety of HIFU turbinoplasty were demonstrated in an animal study. Our results warrant further human clinical trials.

Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies.

Surgical treatment of the inferior turbinates is required for hypertrophic inferior turbinates refractory to medical treatments. The main goal of surgical reduction of the inferior turbinate is to relieve the obstruction while preserving the function of the turbinate. There have been a variety of surgical techniques described and performed over the years. Irrespective of the techniques and technologies employed, the surgical techniques are classified into two types, the mucosal-sparing and non-mucosal-sparing, based on the preservation of the medial mucosa of the inferior turbinates. Although effective in relieving nasal block, the non-mucosal-sparing techniques have been associated with postoperative complications such as excessive bleeding, crusting, pain, and prolonged recovery period. These complications are avoided in the mucosal-sparing approach, rendering it the preferred option. Although widely performed, there is significant confusion and detachment between current practices and their basic objectives. This conflict may be explained by misperception over the myriad of available surgical techniques and misconception of the rationale in performing the turbinate reduction. A comprehensive review of each surgical intervention is crucial to better define each procedure and improve understanding of the principle and mechanism involved.

Microdebrider Assisted Inferior Turbinoplasty: The Evaluation According to the Pathological Causes of Hypertrophied Turbinates

Background: Hypertrophied inferior turbinates are the frequent cause of nasal obstructions.Microdebridoris one of recent advances in technology used for reduction of hypertrophied turbinate to improve nasalbreathing.Objective: To evaluate and compare the effectiveness of microdedrider assisted inferior turbinoplasty onnasal breathing, turbinate size and complications according to the pathological causes.Patients and Method: Aprospective case study of 45 patients with chronic nasal obstruction andhypertrophied inferior turbinates underwent microdebrider assisted tubinoplasty. At Salah-eldeen GeneralHospital and private practice in salah-eldeen governorate, Iraq. During the peroid from June 2016-June2018. The patients were classified according to the cause of turbinate hypertophy and follow up at 1,3,and 12 months post operatievly for nasal bereathing and turbinate size.Results : The preoperative turbinatesize was grade III (48.5%) and grade IV (51.5%). At 1,3,and 12 months post operatively, the grade I andII was (87%). (90%), and (84%) respectively better in compensatory hypertrophy. The subjective patient’ssatisfaction grade I(relieved) and II(improved)) at 1,3, and 12 month after surgery was (100%) (97%) and(89%) respectively more satisfaction with compensatory hypertrophy.Conclusion: The therapeutic success of microdebrider turbinoplasty for improvement of nasal obstructionand turbinate size, according to the causes . In early postoperative period was almost equal,but long-termfollow-up (one year) found it was greater in compensatory hypertrophy and chronic rhinosinusitis andless in allergic and nonallergic rhinitis. There is no significant association between the cause of turbinatehypertrophy and type of complications.

Nasal Cytology in Radiofrequency Turbinate Volume Reduction

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.

Radiofrequency ablation in the treatment of inferior turbinate hypertrophy

Radiofrequency ablation in the treatment of inferior turbinate hypertrophy

Surgical Treatment for the Refractory Allergic Rhinitis: State of the Art

Nasal obstruction is a frequent disorder that interferes with the daily patient’s quality of life. The key element in the pathophysiology of the disorder is the inferior turbinate hypertrophy related to multiple conditions such as allergic rhinitis (AR). Many patients are managed using conventional drug therapies such as antihistamines, decongestants, and intranasal steroid sprays, anticholinergic agents, mast cell stabilizers, and desensitizing vaccines. When traditional therapy failed to relieve AR symptoms, surgical inferior turbinate reduction (ITR) is indicated. A vast variety of surgical techniques have been reported in the literature for AR such as resectioning, coagulating, and laser procedures. We aimed to revise all surgical options in AR management. We confirm that no ideal standard technique for turbinate reduction has been developed so far regarding the multitude of different surgical procedures. Furthermore, no prospective and comparable long-term studies are present in the literature; it is challenging to recommend evidence-based surgical techniques.

Post-operative clinical and radiological assessment after submucosal resection of inferior turbinate and partial inferior turbinectomy

ABSTRACT Background: Hypertrophied inferior turbinates, commonly caused by allergic rhinitis, cause nasal obstruction. Aim of this study: This study aimed to evaluate nasal patency following submucosal resection of the inferior turbinate as a mucosa and bone-preserving method for reducing the size of the hypertrophied inferior turbinate, in comparison with the traditional method (partial inferior turbinectomy). Patient and methods: This study was performed on patients with moderate to severe turbinate hypertrophy, selected from our ear, nose, and throat outpatient clinic, during March 2018 to March 2020. Patients were divided into GROUP I (n = 40; 25 males and 15 females), subjected to microdebridement submucosal turbinoplasty, and GROUP II (n = 40; 22 males and 18 females), subjected to traditional partial inferior turbinectomy. Result: There was a statistically significant decrease in mean nasal obstruction scores and a significant increase in nasal cavity space distance at three levels of the inferior turbinate after 6 months (P < 0.05),. Rhinorrhea and sneezing decreased significantly in both groups after 6 months (P < 0.05), but there was no significant difference between the groups in terms. There was significantly more post-operative bleeding, Crustations, and atrophic rhinitis in the GROUP II than in GROUP I in patients subjected to the traditional partial turbinectomy. Conclusion: These results highlight the superiority of microdebridement to traditional turbinectomy for the management of chronic nasal obstruction, as it demonstrated the highest efficacy and least complications.

Outcome comparison of submucous resection versus combined submucous diathermy and outfracture for treatment of inferior turbinate hypertrophy.

The aim of this study was to compare the outcome of submucous resection and combined submucous diathermy with outfracture technique in treatment of nasal obstruction caused by inferior turbinate hypertrophy. This study is a prospective randomized clinical trial involving 90 patients with hypertrophied inferior turbinate not responding to medical treatment. All patients were selected with equal or near equal mucosal and bony turbinate components using computed tomography (CT) and then randomly allocated into two groups; group A (n = 45): underwent submucous resection in both sides and group B (n = 45): underwent combined submucous diathermy and outfracture in both sides. Subjective (NOSE score) and objective (4-grades endoscopic classification system and PNIF evaluation) measures of nasal airflow were done preoperatively and postoperatively. Subjective assessment using NOSE scale proved that both techniques were effective in relieving nasal obstruction as it improved in both groups postoperatively compared to the preoperative data. However, resection technique was better than diathermy technique with a statistically significant difference (p < 0.05), while objective assessment of nasal obstruction showed better results in resection group than diathermy group, but with no statistically significant difference. Both techniques are effective in relief of nasal obstruction due to inferior turbinate hypertrophy. However, submucous resection showed marked improvement compared to diathermy technique especially at long-term follow-up.

Does inferior turbinate outfracture provide additional benefit when combined with inferior turbinate radiofrequency ablation?

To evaluate, both subjectively and objectively, whether turbinate outfracture provides any additional benefit in the treatment of inferior turbinate hypertrophy when combined with radiofrequency ablation. The study was conducted on 58 patients diagnosed with inferior turbinate hypertrophy. The patients were randomly divided into two groups according to the treatment they receive. Group A consisted of patients undergoing radiofrequency ablation and Group B included patients undergoing turbinate outfracture in combination with radiofrequency ablation. For the purposes of objective evaluation, all patients underwent acoustic rhinometry and anterior rhinomanometry preoperatively and at 6months postoperatively. In addition, for subjective evaluation, the patients completed the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Postoperative changes in objective and subjective parameters in both groups versus the preoperative period and their differences were compared statistically. In Group A, mean postoperative minimal cross-sectional area (MCA) and nasal volume (NV) values and NOSE scores were significantly greater compared to those obtained in the preoperative period. Similarly, Group B showed significantly greater mean postoperative MCA, NV and NOSE score values compared to the preoperative period. In Group A and B, mean postoperative total nasal resistance (TNR) value was significantly lower in comparison to the preoperative period. The differences in mean preoperative and postoperative MCA, NV, TNR and NOSE scores were significantly greater in Group B versus Group A. The addition of turbinate outfracture to inferior turbinate radiofrequency ablation treatment provides both objective and subjective benefits in the resolution of nasal obstruction.

Diode laser versus bipolar diathermy for turbinate reduction in cases of inferior turbinate hypertrophy.

This study was designed to assess the surgical outcomes of two commonly used techniques for turbinate reduction (diode laser and bipolar diathermy) in selected group of patients with chronic nasal obstruction which resulted from inferior turbinate hypertrophy. The current study was conducted on adult patients with a diagnosis of inferior turbinate hypertrophy. 42 patients (21 in each group) with an age range of 21-38years (mean = 26.0 ± 4.1) were included in this work and were randomly distributed in 2 groups: one group was scheduled for diode laser turbinectomy (DLT) while the other group was managed by bipolar diathermy (BDT). In DLT, the machine was on a continuous mode with intermittent loading, with laser energy level set to 6W (0.3-s pulse, 0.1-s break). Pre- and postoperative assessments were statistically compared via tests from SPSS 19.0 (IBM, Chicago, Illinois; USA). Percentage of categorical variables were compared using the Chi-square (χ2) test. P < 0.05 was considered significant, P˃0.05 was considered non-significant, and P < 0.001 was considered highly significant. At 6months postoperatively, in cases of DLT, there was high significant improvement as regards nasal obstruction and headache (χ2 = 64.78 and 39 respectively; P < 0.0001). There was insignificant difference as regards rhinorrhea (χ2 = 5.524; P = 0.137). In comparison to the postoperative data of both groups, significant difference was reported as regards nasal obstruction and headache (P < 0.001) and rhinorrhea (P < 0.05). This study demonstrated that both laser and bipolar cautery are effective in improving nasal obstruction and rhinorrhea. Preservation of the nasal mucociliary function was better in the diode laser group.

The effect of various types of nasal septal deviation, concha bullosa and hypertrophic inferior turbinate on the development of sinusitis

To determine the impact of various types of unilateral nasal septum deviation (NSD), concha bullosa (CB) and hypertrophic inferior turbinate (HIT) on the development of sinusitis. This study was conducted in the Irkutsk State Medical University and the Irkutsk City Clinical Hospital No. 1 from October 2017 to November 2018. By continuous sampling retrospective analysis of 1300 protocols of paranasal sinuses MSCT of adult patients was performed. We used MSCT scanners Somatom Emotion 16 Siemens and GE BrightSpeed 16. The studies were carried out on the patients lying on the back with the subsequent reconstruction on a graphical station in the coronal and axial projections using the slices around 1 mm in the thickness. Inclusion criteria: unilateral or absence NSD. Exclusion criteria: bilateral NSD, chronic polyposis or allergic rhinitis. We have analyzed 272 protocols: 70 without NSD and 172 with unilateral NSD, on the right side - 89 (52%) and on the left - 83 (48%). 108 (44.6%) patients were male and 134 (55.4%) were female with average age 38.5±12 years. All patients were divided into 4 groups by R. Mladina' classification (1987): with NSD types 1, 2, 3, and 5. The results were evaluated using the Yates corrected chi-square and the Fisher's exact test by Statistica 10.0. There were 34 patients with NSD type 1: 12 with sinusitis; 9 had CB: 6 with sinusitis, 3 without it; HIT was in 27 cases: 33% with sinusitis, 67% without it. There were 69 patients with NSD type 2: 12 had sinusitis; 22 had CB: 5 with sinusitis, 17 without it; HIT was in 42 cases: 26% with sinusitis, 74% without it. There were 43 patients with NSD type 3: 26 had sinusitis; 15 had CB: 6 with sinusitis, 9 without it; 30 had HIT: 57% with sinusitis, 43% without it. There were 26 patients with NSD type 5: 11 had sinusitis; 9 had CB: 3 with sinusitis, 6 without it; 24 had HIT: 42% with sinusitis, 58% without it. NSD type 2 was statistically significant prevailed in patients without sinusitis (p=0.000005); NSD type 3 (p=0.03) and the combination of NSD type 1 with contralateral CB (p=0.04) prevailed in patients with sinusitis. NSD type 3 (by R. Mladina), as well as the combination of type 1 with contralateral CB are have influence to the development of sinusitis. CB and HIT are statistically significant prevailed on the contralateral side to unilateral NSD, but do not affect to development of sinusitis.

Patterns of allergic rhinitis among adults in Qassim region, Saudi Arabia: a cross sectional study.

Introductiondeveloping and developed countries have a high prevalence of allergic rhinitis (AR). Severe AR has negative impacts on sleep, quality of life, and work performance. The study aimed to identify the patterns of AR among patients attending the ears nose and throat Unit (ENT) clinic at King Saud Hospital, Qassim, Saudi Arabia.Methodsthis study was a cross-sectional study conducted at the ENT clinic of King Saudi Hospital, Unaizah City, Qassim region, Saudi Arabia. We examined outpatients diagnosed with AR using an interview questionnaire and clinical examination.Resultsthe sample included 455 patients. Of these, 23.7% were 21-30 years old, 65.7% had a family history of AR, 57.8% had no general symptoms, 75.6% reported runny nose as the most common nasal symptom, and 35.4% reported no complications. Dust was the most common trigger of AR (82.4%), 49.2% reported allergic symptoms in all seasons, 96% of patients have inferior turbinate hypertrophy, and oral histamine was the most commonly used treatment (33.2%).Conclusionperineal AR and inferior turbinate hypertrophy were very common findings comparing to previous studies, further studies to assess the risk factors are highly recommended.

Comparison of Different Surgical Treatment Modalities for Nasal Obstruction Caused by Inferior Turbinate Hypertrophy

Background: Hypertrophied inferior turbinates considered the second most frequent contributor to nasal obstruction after septal defects. Various medical measures can be used to treat inferior turbinate hypertrophy (ITH). After failure of medical methods, surgery becomes the cornerstone of management, which is still a controversial issue in the otorhinolaryngology field. Although these surgeries have been practiced for decades, no conclusion has been drawn about the best and optimal choice. Objectives: The objectives were to compare the results between submucosal diathermy (SMD) and partial inferior turbinectomy (PIT) in terms of postoperative bleeding, crusting, dry throat, voice change, postnasal drip, nasal obstruction, need for re-use of medications, and further need for nasal surgery. Subjects and Methods: A prospective observational study involving 100 patients with ITH. Patients were randomly divided into two groups: Group A underwent SMD and Group B underwent PIT. Postoperative follow-up was done at 1 week, 1 month, and 6 months. Results: At 1-week, nasal crusting, postnasal drip, and dry throat were reported more in SMD. At 1-month, nasal crusting and voice change were experienced more in PIT. At 6-month, nasal crusting and voice change occurred more in PIT. Nasal obstruction occurred more in SMD. Re-use of medications and further nasal surgery were more in SMD. Conclusion: SMD is less invasive with fewer complications regarding bleeding and crusting in comparison to PIT, but its effectiveness compared to PIT in re-use of medications and need for further nasal surgery is less.

Effect of septoplasty on inferior turbinate hypertrophy

Background Septal deviation is usually associated with compensatory hypertrophy of the contralateral inferior turbinate. The current treatment of anterior septal deviation is septoplasty, but there is controversy about surgery for the hypertrophied inferior turbinate. Aim This study aims to determine the effect of septoplasty surgery alone on the size of inferior turbinate. Patients and methods This prospective study was done on 40 patients who attended ENT Department of Al-Zahraa University Hospital. This study was done in the period from September 2019 to September 2020. Their age ranged from 18 to 40 years. They had septal deviation on one side and inferior turbinate hypertrophy (ITH) on the opposite side. All of them underwent septoplasty without turbinate surgery. These patients were evaluated preoperatively and 6 months postoperatively by radiological (computed tomography), endoscopic examination, and nasal obstruction symptom evaluation questionnaire. Results Septoplasty alone significantly decreased the thickness of the medial mucosa of hypertrophied inferior turbinate by 1.03±0.74 mm (P=0.000) at the anterior part and decrease by 0.82±1.14 mm at the middle part (P=0.000), with no statistically significant decrease at the posterior part. Moreover, it also decreased the thickness of the lateral mucosa of turbinate by 0.31±0.25 mm (P=0.000) at the anterior part, decrease by 0.42±0.39 mm at the middle part (P=0.000), and no significant decrease at the posterior part. Insignificant change of conchal bone thickness on both sides was reported. Conclusion We conclude that septoplasty alone saves time and cost and avoids complications and sequelae associated with turbinectomy. This in turn improves quality of life, so it can be prescribed for patients with DNS with ITH mainly at anterior and middle segment soft tissue parts, but it is not enough for surgery of patients with ITH of posterior part or conchal bone.

Efficacy of Erb-Laser on Inferior Turbinate Hypertrophy: A Retrospective and Cohort Study.

ObjectivesNasal obstruction (NO) is a very common complaint in the practice of otolaryngology. The cause of NO can be due to inferior turbinate hypertrophy (ITH), which may be a result of allergic rhinitis, hyperreactivity, hormonal causes, rhinitis medicamentosa or idiopathic. The most commonly used treatments today include local nasal or systemic corticosteroids, cauterization or microdebrider, or thermal ablation with radiofrequency, coblation or ablative laser (mainly carbon dioxide or diode lasers), and submucosal reduction. Erbium YAG laser in non-ablative and SMOOTH thermal mode is considered as a non-invasive treatment and could be a novel and safe alternative.The aim of this study was to evaluate the safety and performance of a new Erb-laser treatment protocol on bilateral ITH, during and after 3 sessions of treatment throughout 6 months.MethodsThis retrospective study was carried out over 30 patients with complaints of NO, sneezing, itching, discharge, and nasal congestion refractory to medical management from July 2019 to December 2020 in the Department of Otorhinolaryngology of a private hospital in Famagusta, North Cyprus. Symptoms were evaluated subjectively by using NO Score and Visual Analog Scale (VAS). Patients were evaluated at the post-procedural 1st-week, and 1st-, 3rd-, and 6th-month postoperatively. During each follow-up visit, symptoms were reassessed by VAS and NO Score.ResultsDifferences between pre-operative and post-operative VAS and NO Scores were statistically significant. All patients had significant symptomatic improvements, which started from the post-operative 1stweek and persisted throughout the follow-up period. The active laser treatment showed high improvement during and after the procedure, regarding NO, and decreased the nasal burden on quality of life.ConclusionErbium YAG laser treatment is a simple, safe, effective, and non-invasive method effective on ITH, with minimal damage on the nasal mucosa. It can be done as an office procedure, with minimal complications. This method will provide a great advantage in the future treatment of NO.

Surgical interventions for inferior turbinate hypertrophy.

Nasal obstruction can be induced by various causes; however, inferior turbinate hypertrophy is considered the most frequent cause of this anatomical malfunctioning condition. The current surgical interventional study was focused on comparing the final outcomes of partial inferior turbinectomy (PIT) and powered endoscopic turbinoplasty (PET). The criterion followed for deciding the successfulness of each surgical method was the rate of occurrence of postoperative complications such as bleeding, crustation, and atrophic rhinitis. Fifty patients who suffered from nasal obstruction were randomly divided into two groups: PIT group, with 25 patients, of which 15 (52%) were males and 10 were (48%) females, at an average age of 27.40 ± 7.7 years, and PET group, with 25 patients, out of which 14 (48%) were males and 11 (62%) were females, at an average age of 26.68 ± 6.82 years. The surgical operations were performed at the Department of Otolaryngology, Al-Diwaniyah General Teaching Hospital, Diwaniyah City, Iraq, during the period between March 2015 and March 2020. The PET group showed significantly lower incidence (P < 0.05) of bleeding and crustation than those from the PIT group; however, no significant differences (P > 0.05) were observed between PIT and PET in the occurrence of atrophic rhinitis. PET showed promisingly less postoperative complications when compared to PIT.

Evaluation of preoperative naso-alveolar molding in correction of unilateral complete cleft lip and palate associated with nasal deformity

Background Deviated nasal septum causes variable resistance to inspired air currents, which directly and indirectly influences the efficiency of pulmonary functions. Aim To compare pulmonary function tests performed before and following septoplasty with turbinectomy in patients complaining of nasal obstruction caused by a deviated septum with hypertrophic inferior turbinate. Patients and methods The study was conducted on 60 patients diagnosed with deviated nasal septum with hypertrophied inferior turbinate. All were subjected to complete history taking, external nasal examination, and anterior rhinoscopy, which was performed with a nasal speculum. Additionally, all patients in this study underwent a nasal endoscopy, computed tomography, and spirometry. Septoplasty and turbinectomy were performed for all cases with regular follow‑up, and the spirometry was repeated after 3 months. Results After surgery, the preoperative forced vital capacity (FVC) of 3.14±0.70 increased to 4.43±1.01, with a highly statistically significant difference (P<0.001). Forced expiratory volume in the first second (FEV1) was significantly greater postoperatively (2.66±0.55) than preoperatively (3.96±0.81) (P<0.001). The preoperative FEV1/FVC ratio of 85.08±5.47% improved to 90.39±8.75% after surgery, with a statistically significant increase (P=0.001). The preoperative peak expiratory flow rate of 5.57±1.47 increased to 7.07±2.26 following surgery, a difference that was highly statistically significant (P<0.001). The preoperative forced expiratory flow of 25–75% of vital capacity of 2.73±1.13 increased to 3.73±1.28 after surgery, a change that was highly statistically significant (P<0.001). Conclusion FVC, FEV1, FEV1/FVC, PEF, and forced expiratory flow of 25–75% showed a significant increase after operation. Keywords: pulmonary function, septoplasty, turbinectomy.

Comparison of Endonasal and External Septoplasty for Treatment of Buckled Caudal Septal Deviation

To compare endonasal and external septoplasty for type 2 caudal septal deviations in terms of operative time, aesthetic and functional outcome. Descriptive Analysis. ENT Department, Mayo Hospital/ K.E.M.U, Lahore, from October 2019 to October 2020. Record of patients operated for septal deviations in 2019 were retrospectively reviewed. All patients, diagnosed with type 2 caudal septal deviations, were included; while those with marked inferior turbinate hypertrophy, deviated nasal septum after trauma, and those who could not be followed-up, were excluded. Twenty-eight patients, operated by external approach, were placed in group A; and 32 patients, who had endonasal surgery, were placed in group B. Functional outcome was assessed by nasal obstruction symptom evaluation (NOSE) scale; and cosmetic deformity was assessed by visual analog scale (VAS) pre- and postoperatively at six months. Operative time was measured for both the groups. Sixty patients were included. Mean preoperative NOSE scale score for group A was 67.36 ± 8.07 and postoperative was 15.82 ± 3.62 (p<0.001). Mean preoperative NOSE score for group B was 69.40 ± 5.80 and postoperative it was 18.00 ± 3.75 (p<0.001). Mean VAS score for group A preoperative and postoperative was 18.93 ± 7.86 and 76.07 ± 6.85 (p<0.001), respectively. Mean VAS score for group B preoperative and postoperative was 19.69 ± 7.82 and 71.56 ± 8.84, respectively (p<0.001). Mean operative time for group B was 52.25 ± 3.37 minutes, and for group A 115.00 ± 9.91 minutes (p<0.001). The difference in preoperative and postoperative NOSE and VAS scores compared for both groups revealed p-value of 0.952 and 0.044, respectively. Extracorporeal septoplasty resulted in better aesthetic outcome; though endonasal septoplasty had shorter operative time. Both surgical techniques resulted in good functional outcome. Key Words: Nasal septum, Nasal surgical procedures, Deviated nasal septum, Caudal deviation septum, Septoplasty, Septorhinoplasty, Nasal obstruction symptoms evaluation (NOSE) score, Visual analogue scale (VAS).