Partial Inferior Turbinectomy Research Articles

Endoscopic Submucosal Resection Turbinoplasty and Partial Inferior Turbinectomy for Management of Inferior Turbinate Hypertrophy: A Randomized Clinical Trial

Endoscopic Submucosal Resection Turbinoplasty and Partial Inferior Turbinectomy for Management of Inferior Turbinate Hypertrophy: A Randomized Clinical Trial

Comparative study between surgical partial inferior nasal turbinectomy and coblation assisted inferior turbinate reduction in cases of inferior nasal turbinate hypertrophy

BackgroundThe inferior turbinate is located in the inferior part of the nose, and contribute to the nasal valve formation. Inferior turbinate hypertrophy causes chronic nasal obstruction.AimWe aimed to assess the effectiveness of coblation-assisted reduction of the inferior turbinate hypertrophy using a specially designed coblator probe. Additionally, this study aimed to compare this technique with traditional surgical partial turbinectomy as the control arm and follow up with patients to identify potential complications.MethodsThis study involved 40 patients with nasal obstruction, those patients attended the Otorhinolaryngology Department of Al Azhar University Hospital in Assiut and diagnosed with enlarged inferior turbinate that did not respond to medical treatment. Also, Pre- and post-operative CT scanning was performed to objectively evaluate the improvement.ResultsCoblation group has more advantages over the traditional group like less operative time, less intraoperative blood loss, less post-op pain, less post-op nasal crusts, early return to daily activity (P value < 0.001). Significant decrease in postoperative nasal obstruction among partial inferior turbinectomy group in comparison with coblation group (P value < 0.001).ConclusionCoblation assisted inferior turbinate reduction of the hypertrophied inferior turbinate is the technique of less complications (i.e. post-operative pain, bleeding, and nasal crust), which are commonly encountered with traditional methods. Traditional method is a bit better in patient self-satisfaction after surgery and relieving post-operative nasal obstruction.

The Effect of Topical 5-Fluorouracil Application on Preventing Nasal Adhesions after Endoscopic Partial Inferior Turbinectomy Combined with Submucous Resection of the Nasal Septum

The Effect of Topical 5-Fluorouracil Application on Preventing Nasal Adhesions after Endoscopic Partial Inferior Turbinectomy Combined with Submucous Resection of the Nasal Septum

Endoscopic and Microdebrider-assisted Partial Inferior Turbinectomy in Chronic Nasal Obstruction

Endoscopic and Microdebrider-assisted Partial Inferior Turbinectomy in Chronic Nasal Obstruction

Polysomnographic Assessment on Osahs Outcomes in Patients with Nasal Obstruction Undergoing Septoplasty with Partial Inferior Turbinectomy.

To assess the effect of nasal surgery in improvement in Obstructive Sleep Apnoea Hypopnoea Syndrome in patients with nasal obstruction by Polysomnography (PSG). This study included 30 patients with nasal obstruction who underwent septoplasty and/or turbinate reduction procedure with pre and post operative assessment of respiratory distress index (RDI) including apnoea hypopnoea index (AHI), obstructive apnoea index (OAI), Snoring Index (SI) using polysomnography (PSG). Nasal correction surgery showed statistically significant improvement (p-value < 0.001) in RDI from 13.66 to 6.66, OAI from 6.34 to 3.18 and Snoring Index from 161.77 to 62.23 as assessed by polysomnography. There was statistically significant improvement in minimal saturation levels (during sleep) and positional sleep apnoea. Isolated nasal surgery like septoplasty and/or turbinate reduction improved sleep parameters and alleviated OSA symptoms in patients with static nasal obstruction and obstructive sleep apnoea/hypopnoea syndrome. However, patients with multilevel or dynamic airway obstruction may need further intervention.

Role of interleukin-5 in allergic fungal sinusitis: deeper insight

BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is an allergic response characterized by type 2 inflammatory reactions mediated by T helper 2 cells (Th2). Th2 is characterized by elevated type 2 cytokines related to the humoral response, including Interleukin-4 (IL-4), IL-5, IL-6, IL-9, IL-10, IL-13, IL-25 and IL-33. Allergic fungal sinusitis (AFS) is a distinguishable form of CRSwNP and is characterized by primary localized disease with non-invasive fungal hyphae, which causes immunoglobulin E (IgE)-mediated mucosal hypersensitivity resulting in the formation of eosinophilic mucin. Interleukin-5 (IL-5) is a pro-inflammatory factor that plays a very important role in eosinophil biology.ObjectiveTo explore the relation between IL-5 tissue protein expression and AFS.MethodsA prospective study performed on 70 patients divided into 2 groups (50 cases of AFS and 20 control who underwent septoplasty and partial inferior turbinectomy) to assess the role of IL5 in AFS compared to control.ResultsIL-5 was overexpressed in polyps of AFS patients compared to the control group denoting AFS as an eosinophilic mediated type 2 inflammation and highlighting a positive correlation with Lund MacKay radiological score and Sino-nasal Outcome Test (SNOT-22) score for severity of chronic rhinosinusitis (CRS) symptoms.ConclusionIL-5 plays a pivotal role in the pathogenesis and severity of AFS. Thus, our results provide encouraging evidence supporting targeting IL5 as an eligible therapy of promising benefits in AFS.

Comparison of Conventional Surgical Turbinoplasty Versus Microdebrider Assisted Turbinoplasty in Cases of Inferior Turbinate Hypertrophy

Objective: To compare the conventional surgical turbinoplasty versus microdebrider assisted turbinoplasty in cases of inferior turbinate hypertrophy. Design of the Study: It was a cross-sectional survey. Place and Duration of Study: This study was carried at the Department of ENT Nishtar Medical University and Hospital, Multan from January 2022 to June 2022. Patients and Methods: Patients with hypertrophy of the inferior turbinates, the most common cause of nasal obstruction, were split into two groups of 30. The size of the inferior turbinates was classified as Grade I if they took up less than a third of the nasal cavity, Grade II if they took up more than a third but less than half, and Grade III if they took up more than half. Each group had either a standard partial inferior turbinectomy or a turbinoplasty with the help of a microdebrider. Visual evaluation was used to categorise blood loss during and after surgery. Patients were checked on at 1, 2, 4, and 6 months after surgery. Relief from symptoms and the occurrence of problems such crusting and synechiae formation were evaluated. Results of the Study: Both groups showed comparable significant improvements in nasal blockage. Most patients in the CPIT group experienced intraoperative blood loss of grade II (66.66%) or grade III (10%). When the packs were taken off, 60% of patients experienced grade I blood loss, 36.66% experienced grade II blood loss, and 3% experienced grade III blood loss after surgery. Most patients (46%) and surgeons (40%) in the MAT group experienced grade II or higher intraoperative blood loss. The majority of patients' postoperative blood loss was classified as grade I. Six months later, 6.66 percent of the CPIT group had acquired crusting, and 6.66 percent had developed synechiae. Those that received MAT did not have these problems. Practical implication: The choice of surgical procedure is up to the surgeon's attitude and experience due to the lack of agreement regarding their efficacy. That’s why we compared the effectiveness of these treatment methods for turbinate reduction in order to provide evidence to evaluate the results of the several surgical techniques in local population. Conclusion: According to the findings, both surgical approaches are effective in addressing nasal blockage. Complications are less likely to occur with microdebrider-assisted inferior turbinoplasty since the mucosa and nasal physiology are preserved. Keywords: Microdebrider assisted inferior turbinoplasty, Hypertrophied inferior turbinate, Conventional partial inferior turbinectomy,

Assessment of the Effect of Partial Inferior Turbinectomy on Pulmonary Function Tests

Assessment of the Effect of Partial Inferior Turbinectomy on Pulmonary Function Tests

INCIDENCE OF ATROPHIC RHINITIS AFTER PARTIAL INFERIOR TURBINECTOMY: A RETROSPECTIVE COHORT STUDY

Background: Inferior turbinate hypertrophy is a common nding while evaluating the patients with Allergic Rhinitis, Chronic Rhinitis, Non-Allergic Rhinitis, Hormonal Changes, Acute sinus infection and medications. Turbinate hypertrophy causes signicant impact on patient's quality of life as it causes sensation of nasal obstruction, difculty in sleeping and epistaxis due to altered and turbulent ow of air current in nasal cavity and patients tend to go for surgical management when the medical management fails. The nasal obstruction is generally relieved after surgery but patient with a roomy nasal cavity is also at risk of developing Atrophic Rhinitis. We present a retrospective cohort study to compare the incidence of post operative Atrophic Rhinitis in two groups with one group of patients undergoing Partial turbinectomy under endoscopic guidance and other group undergoing turbinate reduction using a Turbinate Scissor. All the patients included in the study underwent the procedure in the Department of Otorhinolaryngology-Head and Neck Surgery in MBS Hospital, Kota over a period from July 2020 to December 2021. This retrospective study includes 126 pa Methods: tients as per the inclusion criteria described in the following article out of which 74 patients (52M, 22F) underwent Partial Inferior Turbinectomy using a microdebrider under endoscopic guidance and 52 patients (37M, 15F) underwent the Procedure using Turbinate scissors and the incidence of Atrophic Rhinitis was noted in the post operative follow up period and the data obtained was put to statistical evaluation. Atrophic Rhinitis was noted in a total Results: of 2 patients out of which 1 patient underwent the procedure using microdebrider and1patient underwent the procedure using Turbinate scissors. It was noted that there was no difference in gender distribution of Atrophic Rhinitis as well as the use of Microdebrider did not offer any advantage in reducing the incidence post operative Atrophic Rhinitis (p-value 0.811).

Submucosal thulium laser turbinoplasty in children: assessment of efficacy and comparison with partial inferior turbinectomy.

This study aimed to assess efficacy of submucosal thulium laser turbinoplasty in children and to compare thulium laser turbinoplasty with partial inferior turbinectomy. This is a retrospective study over 10years from 1 January 2009, conducted in a Pediatric Otorhinolaryngology Department in a university tertiary care center, including all the children who underwent thulium laser inferior turbinoplasty and partial inferior turbinectomy. The main outcome measures were the improvement in airflow using rhinomanometric cumulative flow at 150Pa and then functional improvement using "OPERAS" score (nasal Obstruction, facial Pain, Epistaxis, Rhinorrhea, Anosmia, Sneezing). Eighty-six children underwent 47 submucosal thulium laser turbinoplasties and 48 partial turbinectomies. After submucosal thulium laser turbinoplasty, the cumulative flow at 150Pa improved from 308.2 to 454.4 cm3s-1 (p < 0.01) and the OPERAS score decrease was 1.5 point (p < 0.01). Daily use of intra nasal corticosteroid and antihistamine both decreased significantly. No local complications of this technique have been reported. Partial turbinectomies show a higher reduction of the OPERAS score and a better improvement of rhinomanometric parameters, but also a significantly higher complication rate. Submucosal thulium laser turbinoplasty is a good compromise between safety and efficacy, with substantial functional and rhinomanometric postoperative improvement.

Inferior Turbinate Surgery: Difficulties Between the Decision-Making and the Selection of Proper Technique

Back ground and Objectives The inferior conchae have important role in the maintenance of nasal airflow via providing the nasal valve mechanism but increase of inferior turbinate bulk may result in significant nasal obstruction. Therefore, this may need further surgical intervention to deal with these bulky conchae but it is very necessary to balance between the mechanical as well as the functional patency of the nose. Thus, through this surgery it become difficult to decide whether the patient is a candidate for surgery and which technique is suitable for that particular patient. Patients and Methods Two- thousands three- hundreds and six patients aged 3-65 years of hypertrophied inferior conchae, had been diagnosed as a cases of mechanical nasal obstruction due to hypertrophied inferior conchae (HIC). The patients operated by two techniques of inferior conchae surgery, which are sub-mucosal diathermy (SMD) and partial inferior turbinectomy (PIT). The outcomes were correlated to different factors to assess as much as possible the clear conclusion for this significant issue in rhinology. Results and Conclusion The proper selection of patient for this pattern of surgery is considered as one of main aspects of this issue and one of significant steps toward the resolving of this dilemma it is very necessary to select the most suitable candidate for this surgery. On the other hand, the type of the technique for this surgery is needed to be selected probably.

Ho:YAG 레이저를 이용하여 제거한 하비갑개에 발생한 동정맥기형 1례

Vascular malformations are rare vascular diseases composed of improperly connected vasculature. Arteriovenous malformations (AVMs), havening direct communication between artery and vein without capillary beds, are rare among all vascular malformations. Most AVMs are found intracranially, extracranial AVMs mostly affect the head and neck area. We report an unusual case of a 52-year-old female who was presenting nasal obstruction and diagnosed with AVM originated from the inferior turbinate as a final pathology. Preoperative selective embolization and complete excision of the tumor is the gold standard to treat AVM due to its rich vascular formation. As Holmium:yttrium-aluminium-garnet laser (Ho:YAG laser) is well-known for photocoagulation, hemostasis, and precise excision of tissue, we performed partial inferior turbinectomy with Ho:YAG laser without preoperative selective embolization. The patient was followed-up for four years and did not presented any other nasal symptoms. By this case, we propose that surgical excision with Ho:YAG laser without preoperative selective embolization is feasible for treatment of small AVM without invasion of adjacent tissue. (J Clinical Otolaryngol 2021;32:281-285)

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.

COMPARATIVE STUDY ON IMPROVEMENT OF NASAL SYMPTOMS FOLLOWING SEPTOPLASTY WITH PARTIAL INFERIOR TURBINECTOMY VS SEPTOPLASTY ALONE IN ADULTS WITH DEVIATED NASAL SEPTUM

BACKGROUND: Nasal obstruction is a common presenting symptom which otolaryngologists encounter in daily clinical practice. One of the most common cause of nasal obstruction is deviated nasal septum(DNS). DNS to one side is associated with overgrowth of inferior turbinate on the contralateral side. Septoplasty alone or septoplasty with inferior turbinate reduction is the mode of treatment but that depends upon the decision of the operative surgeon. In this study we aim to collect data and come to a conclusion as to which surgery is benecial for the patients. AIMS AND OBJECTIVES: (1) To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy versus septoplasty alone by NOSE Scale. (2) To corroborate the subjective ndings of NOSE Scale by rhinomanometry and nasal endoscopy. METHODOLOGY: A prospective and comparative study was done on 60 patients over a period of 1 year in a tertiary care centre. Patients were alternatively divided into two surgical groups Group A- septoplasty with partial inferior turbinectomy and Group B- septoplasty alone. Nasal Obstruction Symptom Evaluation(NOSE) was used for subjective evaluation of nasal symptoms. Rhinomanometry was used as a tool for objective evaluation of symptoms. Data was analysed using tables, graph and percentage and test of signicance. Post operative improvement RESULTS: following both group A septoplasty with partial inferior turbinectomy and group B Septoplasty alone was signicant at post op 1,3 and 6 months respectively. When both groups were compared those undergoing partial inferior turbinectomy with septoplasty had highly signicant results by NOSE scale as well as rhinomanometry and endoscopy. This study showed tha CONCLUSION: t hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal symptom with contralateral turbinate hypertrophy. Thus we can conclude that partial inferior turbinectomy should be done in addition to septoplasty as it is a highly effective modality for treatment of nasal obstruction in patients of nasal obstruction in patients with deviated nasal septum.

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.

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.

A Case of Choanal Polyp Originated from the Inferior Turbinate

The choanal polyp, originating from inferior turbinate, is known to be extremely rare. We report a case of a 65-year-old woman who was treated for choanal polyp originating from inferior turbinate. She had felt left nasal obstruction for two weeks. In the endoscopic examination, polypoid tissue covered with the mucopurulent discharge was observed filling the left inferior meatus. An ovoid homogenous enhancing lesion in the left posterior nasal cavity around the inferior turbinate was observed on CT and MRI. Endoscopic mass excision with partial inferior turbinectomy was performed under general anesthesia. The pedicle of the polyp was observed on the posterior side of the inferior turbinate. Complete resection including the mucosa around the pedicle of the choanal polyp was performed. The patient was followed up for seven months without any recurrence or complications.

Mini Inferior Turbinoplasty-Tunneling Technique Versus Conventional Partial Inferior Turbinectomy in Adults: A Comparative Study

Background: Inferior turbinate reduction is a well-described procedure performed whenever medical treatment for patients with hypertrophic inferior turbinates or vasomotor rhinitis fails. There are several techniques of turbinate reduction that include turbinectomy, submucous diathermy, inferior turbinoplasty, cryotherapy, CO2 laser turbinoplasty, Coblation channelling and others. Each technique is associated with its own short-term and long-term complications such as bleeding, crusting and recurring of the turbinate hypertrophy.Materials and Methods: We studied 80 patients attending the ENT department outpatients at Aswan university hospital from June 2018 to June 2019. All patients were clinically and radiologically diagnosed with bilateral inferior turbinate hypertrophy without response to medical treatment. Patients were randomized to two groups: Group A patients that underwent Mini turbinoplasty using tunnelling techniques and Group B patients that had conventional partial inferior turbinectomy Technique.Results: The intraoperative time was longer in group A patients who had turbinoplasty-tunneling technique compared to group B who had conventional partial turbinectomy. However, intraoperative blood loss and nasal Packing were required mostly in group B patients. Postoperative bleeding and crustations were significantly higher in group B patients. There was no significant difference regarding the percentage synechia between both groups. Nasal obstruction symptom markedly improved in group B patients.Conclusion: The current study revealed that Conventional Partial Inferior Turbinectomy is better than Mini Inferior Turbinoplasty Tunneling Technique regarding relief of symptoms of nasal obstruction.

Partial inferior turbinectomy versus submucosal diathermy in hypertrophied inferior turbinates

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; The study aims to compare the efficacy of submucosal diathermy and partial inferior turbinectomy in terms of improvement in nasal obstruction, pain, haemorrhage, crusting and wound healing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective sequentially randomized comparative study involving fifty patients, divided into two groups of 25 patients each. Group A consists of patients who underwent SMD and group B consists of patients who underwent PIT. Post-operative assessment was done at day 1, 2 weeks, 1 month, 3 months and 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Post-operative improvement in nasal obstruction was seen in both groups. 80% showed significant improvement in SMD and 32% in PIT group at the end of second week. By sixth month, 40% in SMD group and 80% in PIT group showed significant improvement. Mild pain was observed in 12% of PIT group at 2 weeks. In SMD group, 8% developed reactionary haemorrhage. In PIT group, 24% developed minimal soakage and 12% developed moderate soakage. Severe nasal crusting was seen in 64% of the cases in PIT group and in 40% of the cases in SMD group at second week. By 1 month, 44% in PIT group and 12% in SMD group showed severe crusting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Short term complications like pain, obstruction and haemorrhage was noted to be higher with PIT. On long term evaluation, PIT showed better results in terms of improvement in nasal obstruction scores.&lt;/p&gt;

Using intranasal splints after septoplasty operations: a prospective cohort study

Background Intranasal splints are widely used after septoplasty for prevention of intranasal adhesions. However, they have been shown to cause significant discomfort. Aim To evaluate the use of intranasal splints after septoplasty. Patients and methods This randomized study included 50 consecutive patients who underwent endoscopic septoplasty and bilateral partial inferior turbinectomy. They were divided randomly into two groups (A or B). In only group A, intranasal splints were placed in both nostrils before packing. Nasal splints were removed after 7 days of surgery. Assessment of the nasal cavity, using the nasal endoscope and the Arab NOSE scale, for nasal obstruction was done at 1 and 6 weeks after septoplasty. Pain and discomfort after operation were evaluated using the visual analog scale. Results There were 26 (52%) males and 24 (48%) females. The age range of patients was between 19 and 48 years old. They were divided into two groups: A (splinted) and B (nonsplinted). One week after operation, group A results showed higher numbers regrading nasal obstruction, as well as pain and discomfort after operation (P=0.047 and 0.001 in the order). Six weeks after septoplasty, group B results regarding intranasal adhesions and nasal obstruction were significantly more than group A (P=0.001 and 0.021, respectively). Conclusion Using intranasal splints effectively decreases intranasal adhesions after septoplasty, although it may be accompanied with pain, discomfort, and nasal obstruction in the early postoperative period.