Long‐Term Results of Inferior Turbinate Hypertrophy with Radiofrequency Treatment: A New Standard of Care?

OBJECTIVE: The objective of this study was to report the long-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) and to compare this with other accepted surgical treatments of inferior turbinate hypertrophy. STUDY DESIGN AND SETTING: Prospective, 2-year follow-up of 19 patients originally enrolled in a prospective, randomized, single blinded, placebo controlled trial for treatment of inferior turbinate hypertrophy with RFVTR. Patients evaluated their severity of obstruction, frequency of obstruction, and overall ability to breathe by way of a 10 cm visual analogue scale. RESULTS: RFVTR for inferior turbinate hypertrophy showed continued benefit at 2 years posttreatment, with no indication of increasing symptomatology. The benefit demonstrated in frequency of obstruction, severity of obstruction, and overall ability to breathe (P < .05) was maintained at 2 years. No complications occurred. Review of the literature shows lower short- and long-term complications for RFVTR compared with other surgical methods CONCLUSION: RFVTR is effective in treating inferior turbinate hypertrophy with sustained benefit at 2 years follow-up while resulting in fewer complications than other surgical methods. Significance: RFVTR is a relatively new procedure, and therefore there are few long-term evaluations of its effectiveness; this is the first prospective study to document successful outcomes at 2 years follow-up.     

Radiofrequency for inferior turbinate hypertrophy: could its long-term effect be predicted with a preoperative topical vasoconstrictor drop test?

BACKGROUND: Our purpose was to evaluate whether postoperative improvement by radiofrequency (RF) volumetric tissue reduction (RFVTR) correlated with a preoperative topical vasoconstrictor drop test (TVDT) in subjects with chronic nasal obstruction secondary to inferior turbinate hypertrophy (ITH). METHODS: This study was a prospective and unblinded clinical trial. We included 22 subjects suffering from chronic nasal obstruction secondary to ITH. TVDT was performed on all subjects before the operation, and RF energy was delivered to three different sites of each turbinate. Nasal obstruction was evaluated by visual analog score (VAS) preoperatively, after TVDT, and 1, 2, 4, 6, 8, 12, and 24t weeks after surgery. Success rates of RFVTR and gain ratios of RFVTR and TVDT were calculated. RESULTS: Significant improvements were observed in success ratios by RFVTR between the 2nd and 12th weeks. Postoperative VAS values reached to VAS value achieved by TVDT at the 8th week. Correlation analysis revealed that postoperative VAS values found at the 2nd to 24th weeks correlated positively with VAS values achieved by TVDT (r = 0.47 and p < 0.03 at the 2nd week; r = 0.65 and p = 0.001 at the 24th week) but not with preoperative VAS values. Similar positive correlations also were found between gain ratios of TVDT and RFVTR from the 4th to 24th weeks. CONCLUSION: This study showed that success by RFVTR in ITH could be predicted by preoperative TVDT. Improvement by RFVTR depends on how much the patient's turbinates respond to TVDT, but not how much he/she complains of nasal obstruction.     

等离子低温射频消融治疗鼻塞疗效评价

目的评价等离子低温射频治疗下鼻甲肥厚的主观远期疗效。方法采用前瞻性非随机研究,均为门诊患者。美国Afthrocare等离子低温射频手术系统行下鼻甲消融,VAS评分法评价治疗前后鼻塞程度,t检验分析治疗前,治疗后2个月,治疗后1年疗效差异。结果治疗前后VAS统计学差异显著,1年后满意率100％,1次治疗满意率95％,除1例感染外,无其他并发症。结论等离子低温射频是目前下鼻甲肥大消融治疗的微创、安全、有效的方法。     

Submucosal bipolar radiofrequency thermal ablation of inferior turbinates: a long-term follow-up with subjective and objective assessment

OBJECTIVE: To assess the efficacy and morbidity of bipolar radiofrequency thermal ablation of the inferior turbinates in patients with nasal obstruction caused by turbinate hypertrophy. STUDY DESIGN: Prospective, nonrandomized study and outpatient treatment. METHODS: Twenty patients (age range, 23-77 y; median age, 52 y) enrolled in the study. There was one dropout. All the patients had nasal blockage despite medical treatment. Bipolar radiofrequency thermal ablation was delivered to inferior turbinates at 100 kHz with a voltage root mean square value of 168 to 182. The preoperative and postoperative nasal functions were investigated by immediate and long-term visual analogue scale (VAS) scores of symptom parameters, olfactory thresholds, saccharine transit time, rhinomanometry, and acoustic rhinometry. The follow-up was conducted at 1 week and 3, 6, and 12 months. RESULTS: The VAS scores of subjective complaints (nasal discharge, itching, sneezing, crusting) decreased, and the VAS scores of evaluation of the effectiveness (frequency of nasal obstruction, degree of nasal obstruction, and patient satisfaction) increased statistically significantly in the 12-month follow-up without relapses. There were no adverse effects on nasal epithelial clearance time and olfactory functions. In rhinomanometry the changes in total nasal resistance and response to the vasoconstrictor agent were not statistically significant. In acoustic rhinometry the change in the sum of both nasal cavity volumes from nostril to 5 cm was statistically significant 6 and 12 months after the treatments. The difference between the preoperative and postoperative vasoconstrictive effect was not statistically significant. CONCLUSION: The bipolar radiofrequency thermal ablation of inferior turbinates is a promising alternative, which should be considered when planning inferior turbinate interventions.     

Radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates: a new method in the treatment of chronic nasal obstruction

Twenty-two Caucasians (16 male and 6 female) with chronic bilateral nasal obstruction due to hypertrophic inferior turbinates were followed up over a three-month period. They were assessed by clinical examination, as active anterior rhinometry, and acoustic rhinometry before and after topical decongestion, preoperatively and three months after surgery. All patients were treated by application of radiofrequency-volumetric-tissue reduction (RFVTR, or somnoplasty) to both inferior turbinates. Initial postoperative edematous response disappeared during the first week after RFVTR. Three months postoperatively 20 of 22 patients (91%) reported subjective improvement of nasal patency. The average cross-sectional area for both sides of the nasal cavity (measured at the head of the inferior turbinate (C-Notch) before decongestion) increased in 15 of 22 patients (68.2%). This means a significant improvement from 1.24 to 1.49 cm2 for both sides of the nasal cavity (p = 0.0054). We conclude that RFVTR can safely reduce turbinate volume in a precise manner in patients with nasal obstruction due to hypertrophic inferior turbinates.     

射频消融治疗下鼻甲肥厚所致鼻塞的疗效

目的 :探讨射频消融治疗下鼻甲肥厚所致鼻塞的效果。方法 :对 18例下鼻甲肥大致鼻塞患者采用射频消融术缩小双侧下鼻甲 ,术前及术后 3个月应用视觉模拟评分表 (VAS)来评价鼻塞的主观感觉。结果 :患者术前鼻塞VAS评分左侧为 (6 7.7± 9.4 ) % ,右侧为 (70 .5± 10 .5 ) % ;术后 3个月左侧为 (4 5 .0± 9.0 ) % ,右侧为(5 3.3± 11.6 ) % ,左右侧分别与术前比较 ,差异均有极显著性意义 (均P <0 .0 1)。随访 3个月 ,检查双侧下鼻甲与鼻中隔的最小距离从术前小于 0 .2cm增加到术后大于 0 .3cm。结论 :射频消融术是安全、有效、微创地治疗下鼻甲肥大所致鼻塞的较好治疗方法     

Coblation versus microdebrider-assisted turbinoplasty for endoscopic inferior turbinates reduction

ObjectivePatients suffering from persistent inferior turbinates hypertrophy refractory to medical treatments require surgical intervention where the main aim is symptomatic relief without any complications. Extraturbinoplasty is one of the preferred procedures for turbinate reduction due to its efficacy in freeing up nasal space by removing the obstructing soft tissue and bone while preserving the turbinate mucosa. We sought to evaluate the effectiveness and safety of microdebrider assisted turbinoplasty (MAT) and coblation assisted turbinoplasty (CAT) performed as an extraturbinoplasty procedure.MethodsA prospective randomized comparative trial was conducted among patients with bilateral nasal blockage secondary to inferior turbinates hypertrophy. Patients were randomly assigned to MAT or CAT. An extraturbinal medial flap turbinoplasty was performed for both techniques. Symptom assessment was based on the visual analogue score for nasal obstruction, sneezing, rhinorrhea, headache and hyposmia. Turbinate size, edema and secretions were assessed by nasoendoscopic examination. The assessments were done preoperatively, at 1st postoperative week, 2nd and 3rd postoperative months. Postoperative morbidity like pain, bleeding, crusting and synechiae were documented. The clinical outcomes of both techniques were analyzed using repeated measures ANOVA.ResultsA total of 33 participants were recruited, 17 patients randomized for MAT and 16 patients for CAT. Nasal obstruction, discharge, sneezing, headache and hyposmia significantly reduced from 1st week until 3 months for both procedures. Similar significant reductions were seen for turbinate size, edema and secretions. However, there was no significant difference in symptoms and turbinate size reduction were seen between both groups at the first postoperative week, 2nd and 3rd postoperative months. There was significant longer operating time for CAT when compared to MAT (p = 0.001). The postoperative complications of bleeding, crusting and synechiae did not occur in both groups.ConclusionBoth MAT and CAT were equally effective in improving nasal symptoms and achieving turbinate size reduction in patients with inferior turbinate hypertrophy. Both MAT and CAT offer maximal relieve in patients experiencing inferior turbinates hypertrophy by removing the hypertrophied soft tissue together with the turbinate bone without any complications.     

射频消融术治疗慢性肥厚性鼻炎

目的：探讨射频消融治疗慢性肥厚性鼻炎所致鼻塞的效果及对鼻黏膜功能的影响。方法：采用射频消融术治疗慢性肥厚性鼻炎60例的双侧下鼻甲，术前及术后3个月应用视觉模拟评分表（visual analogue scale, VAS）评价鼻塞的主观感觉；应用糖精试验法测定术前及术后3个月的鼻腔黏膜纤毛输送率（mucociliary transport rate, MTR）。结果：术前鼻塞VAS评分左侧为（68.7±9.6）%，右侧为（72.5±10.2）%；术后3个月左侧为（35.0±9.0）%，右侧为（40.3±10.6）%，与术前相比，差异均有统计学意义（P＜0.01）。随访3个月，双侧下鼻甲与鼻中隔的最小距离从术前小于0.2?cm增加到术后大于0.3?cm。术前鼻黏膜纤毛MTR为（7.64±1.56）mm/min，术后3个月鼻黏膜纤毛MTR为（6.89±2.01）mm/min，与术前比较差异无统计学意义（P＞0.05）。结论：射频消融术是治疗慢性肥厚性鼻炎所致鼻塞的较好方法，对鼻黏膜纤毛无明显影响，未破坏鼻黏膜纤毛的正常生理功能     

A stereological study on the correlation of inferior turbinate hypertrophy and paranasal sinus disease

The objective of this study is to investigate the correlation between inferior turbinate size and paranasal sinus opacification on computerized tomography (CT) scans. Paranasal sinus CT scans of a total of 185 patients (92 males, 93 females) were examined in terms of sinus opacification. Sizes of the inferior turbinates were measured using stereological method and these sizes in normal and opacified paranasal sinuses are compared using one-way analysis of variance. Scans of 185 patients (93 female, 92 male) aged between 12 and 84 (mean 37.85 ± 16.27) years were examined in this study. Sizes of the inferior turbinates were found to be increased significantly in case of opacification of ipsilateral maxillary and anterior ethmoid sinuses (p = 0.000 and p = 0.4, respectively) on both sides. On the other hand, such a relationship could not be demonstrated for sizes of inferior turbinates with opacified or non-opacified posterior ethmoid, frontal and sphenoid sinuses. In conclusion, the combination of CT and the Cavalieri principle can provide an unbiased, direct, and assumption-free estimate of the regions of interest. The presented method can be efficiently applied without any need for special software, additional equipment, or personnel than that required for routine CT in daily use. Paranasal sinus disease, especially the inflammatory diseases of maxillary and anterior ethmoid sinuses, must be carefully investigated in cases with inferior turbinate hypertrophy.     

Evaluation of radiofrequency thermal ablation results in inferior turbinate hypertrophies by magnetic resonance imaging

OBJECTIVES: Nasal obstruction caused by inferior turbinate hypertrophies is one of the most frequent problems in otolaryngology. Treatment of this disease may involve medical and surgical methods. Thermal ablation with radiofrequency energy has become quite popular in the recent years as one of the surgical methods used when medical therapy is not adequate. STUDY DESIGN: Prospective, clinical trial. METHODS: Thermal ablation with radiofrequency energy was used in this study on the inferior turbinates of 21 patients who had nasal obstruction caused by inferior turbinate hypertrophy only. The results were evaluated subjectively by preoperative and postoperative patient- and physician-assigned visual analogue scales and objectively by magnetic resonance imaging (MRI) investigation. RESULTS: By the end of the postoperative week 10, 64.76% recovery was detected according to the patient evaluation, and 40.75% recovery was detected according to the physician evaluation. Measurement of the average volumes of the inferior turbinates by MRI revealed a 8.70% postoperative reduction. The most significant change was detected in the anterior-posterior length measurement performed in the axial plane. CONCLUSIONS: These results suggest that thermal ablation with radiofrequency energy is an easily applied, efficient, and reliable technique in treatment of the inferior turbinate hypertrophy, and that anterior-posterior length measurement in the axial section of the inferior turbinate by MRI, which is thought as an objective evaluation method, could be an efficient diagnostic tool in detecting the efficiency of radiofrequency on inferior turbinate.     

Cryosurgery of the inferior nasal turbinates

Forty-seven patients with irreversible nasal obstruction due to inferior turbinate hypertrophy were treated by cryosurgery, the short and medium term results having been clinically evaluated. Permanent good results in nasal breathing were achieved in 83% of the patients. Failures are mostly related to turbinates hypertrophy due to nasal allergy. The combination of cryosurgery and nasal septoplasty, in cases of hypertrophy associated with deformities of nasal septum, gives an excellent result. Cryosurgery of hypertrophic nasal turbinates is a simple, safe, and reliable procedure to improve nasal breathing in cases of nasal turbinate hypertrophy.     

Long-term results of trimming of the inferior turbinates

The long-term benefit of trimming of the inferior turbinates for nasal obstruction is unclear and our aim was to assess this. Fourteen patients who had had pre-operative nasal symptom scores and anterior rhinomanometry prior to inferior turbinate resection were reassessed at least 7 years post-operatively. Both nasal symptom scores for obstruction and nasal resistance had increased significantly in the intervening time period. Nasal crusting and hypertrophy of the cut inferior turbinate are considered to be responsible for this. Patients should be warned some degree of nasal obstruction may recur post-operatively.     

Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum

OBJECTIVE: To measure the dimensions, composition, and possible structural and/or histopathological changes of the compensatory hypertrophic inferior turbinate in patients with deviated nasal septum. STUDY DESIGN: A prospective, nonrandomized, and morphometric study. METHODS: Nineteen patients with deviated nasal septum and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity underwent surgery for correction of nasal obstruction. Patients' specimens were compared with those of a control group consisting of 10 inferior turbinates removed at autopsy. Quantitative measurements of the inferior turbinate histological sections were carried out and included the width of the layers and morphometric calculations of the relative proportions of the soft tissue constituents. Also, qualitative study was performed to detect pathological changes. RESULTS: Of all layers, the inferior turbinate bone underwent a twofold increase in thickness and manifested the most significant expansion (P < or =.001), whereas the contribution of the mucosal layers to the inferior turbinate hypertrophy was modest. The morphometric analysis revealed a larger proportion of venous sinusoids in hypertrophic turbinates, but the difference was small and statistically insignificant. Qualitative assessment disclosed normal mucosal architecture in all inferior turbinates with compensatory hypertrophy. Eleven remained intact, while eight disclosed mild to moderate pathological changes. CONCLUSIONS: The data gathered in the present study are of importance to the decision-making process regarding turbinate surgery. The significant bone expansion and the relative minor role played by the mucosal hypertrophy would support the decision to excise the inferior turbinate bone at the time of septoplasty.     

Comparison of the effects of radiofrequency tissue ablation,CO2 laser ablation,and partial turbinectomy applications on nasal mucociliary functions

OBJECTIVES: One of the major causes of chronic nasal airway obstruction is disease of the inferior turbinate. However, there is no agreement on how to deal with this problem. Comparison was made of the nasal functions after treatment by radiofrequency tissue ablation, laser ablation, and partial turbinectomy using subjective symptom scores and objective tests. STUDY DESIGN: Prospective, randomized clinical trial. METHODS: The study was conducted on three groups of 45 adult volunteer patients with symptoms and signs of nasal obstruction and stuffiness related to enlarged turbinates. In group A, laser ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group B, radiofrequency tissue ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group C, patients who were not treated by any surgical techniques were the control subjects. Clinical examinations, visual analogue scales, rhinomanometry, and isotopic study of nasal mucociliary transport time were used to assess treatment outcomes. RESULTS: At 12 weeks after surgery, the nasal mucociliary transport time results were compared in the same patients. The average time was 25.60 minutes on the side where laser ablation was applied and 11.40 minutes on the side where partial turbinectomy (PT) was applied. In the patients on whom radiofrequency tissue ablation and partial turbinectomy were applied, the average nasal mucociliary transport time was 10.33 minutes on the radiofrequency tissue ablation side, whereas it was 11.33 minutes on the partial turbinectomy side. Rhinomanometric measurements demonstrated a significant decrease in nasal resistances at 12 weeks in both sides in groups A and B. CONCLUSIONS: In the study it was demonstrated that radiofrequency tissue ablation to the turbinate is effective in improving nasal obstruction objectively and in preserving nasal mucociliary function. Laser ablation of the turbinate is effective in improving the nasal obstruction; however, it disturbs the mucociliary function significantly. With the partial turbinectomy technique, results obtained were similar to the results with the radiofrequency tissue ablation technique.     

Die Behandlung der hypertrophen unteren Nasenmuschel.¶Teil 1

Chronic nasal obstruction is a common disorder, mostly caused by hypertrophied inferior turbinates. If there is inadequate response to conservative medical management, the inferior turbinates should be reduced. The choice of treatment is mainly influenced by whether the nasal airway obstruction is due to hypertrophic mucosa or to an enlarged turbinate bone. The first part of this review describes the various surgical modalities for treatment of swelling of the turbinal mucosa. The indications, advantages, disadvantages, complications, and controversies of each modality (submucous diathermy, cryosurgery, infra-red coagulation, argon-plasma coagulation, radiofrequency, laser surgical techniques) are reviewed and discussed.     

Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy

Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the effectiveness and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold coblation turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied prospectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent different surgical methods of turbinate reduction, divided into two groups: (1) in 30 patients, inferior turbinate volume reduction using ultrasound procedure on the left side and monopolar diathermy on the right was performed; (2) in 30 patients, radiofrequency coblation technique on the left side and ultrasound turbinate reduction on the right side was undertaken. Subjective evaluation of nasal obstruction and pain was performed using visual analog scales and objective evaluation of the surgical outcome was obtained using active anterior rhinomanometry and acoustic rhinometry. Examinations were performed preoperatively, and 1, 3 and 6 months after surgery. Both subjective and objective evaluation showed significant postoperative improvement in all cases. The best results were obtained with the ultrasound procedure, and second with the radiofrequency technique. The least improvement was observed in the electrocautery group, although its results did not differ significantly from the radiofrequency group. It may be, thus, concluded that ultrasound turbinate reduction is an effective and safe procedure for the management of chronic hypertrophic rhinitis, in patients failing to respond to medical treatment. Using this method, better results were obtained in decreasing subjective symptoms and nasal obstruction, in comparison with radiofrequency and electrocautery.     

Long-term self-reported treatment effects and experience of radiofrequency-induced thermotherapy of the inferior turbinates performed under local anesthesia: a retrospective analysis

Nasal obstruction due to inferior turbinate hypertrophy is a common complaint. Radiofrequency-induced thermotherapy of the inferior turbinates (RFITT) under local anesthesia is now a widely used treatment, however reports of assessment of the long-term self-reported benefits and patient satisfaction of the treatment are scarce. This study focuses on the self-reported long-term effects of treatment and experience of RFITT. A questionnaire was sent to 441 patients who underwent RFITT in our clinic to treat symptoms of impaired nasal passage due to enlarged inferior turbinates. All patients had enlarged inferior turbinates on nasal examination. Patients were included if RFITT was done under local anaesthesia, was performed more than a year before the questionnaire was forwarded and on the indication-significant nasal obstruction because of enlarged inferior turbinates. Improvement of nasal breathing (by means of a Visual Analog Scale, VAS), changes in use of nasal spray (VAS), usage of pain medication, patient friendliness of the treatment, complaints reported after treatment, permanent effect of treatment during day and night time and willingness to recommend treatment to others were analyzed. No significant post-operative complications were observed. There was a significant reduction in use of nasal spray and the majority of patients interviewed reported long-term positive effects of RFITT during the daytime. This study shows that RFITT performed under local anesthesia is a valuable, minimally invasive, patient-friendly and well-tolerated treatment in patients with impaired nasal passage due to inferior turbinate hypertrophy.     

等离子下鼻甲部分消融术与吸切钻下鼻甲部分切除术

目的比较等离子下鼻甲部分消融术与吸切钻下鼻甲部分切除术对慢性肥厚性鼻炎患者术中、术后的影响。方法等离子组患者25例,对照组14例。等离子组用低温等离子射频消融系统连接45号刀头,行下鼻甲前、后部中隔侧的4～6通道消融。对照组用吸切钻自前向后切割下鼻甲肥厚黏膜,术后需填塞止血2日。术后患者对疼痛和鼻堵程度采用VAS评分。术前、术后1个月、3个月、6个月均由医师对每侧下鼻甲进行评分,由患者评估鼻堵程度和频度。结果等离子组术中出血较对照组明显减少,术后疼痛和鼻堵程度较轻。术后1个月等离子组和对照组的鼻堵程度、鼻堵频度和下鼻甲体积较术前均有明显改善,二者改善的程度无明显差别。术后3个月两种术式均疗效稳定且等离子组鼻堵频度进一步改善。术后6个月两种术式疗效依然稳定。结论等离子下鼻甲部分消融术创伤小,术中、术后出血少,痛苦小;术后1个月患者主观症状与客观体征均有明显改善;术后3个月患者主观症状进一步改善;术后6个月内疗效均稳定且与吸切钻下鼻甲部分切除术疗效相当。     

Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty

IntroductionMechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent.ObjectiveThis study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms.MethodsThe research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients’ preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale.ResultsThe mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05).ConclusionThe data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).     

Effects of turbinoplasty versus outfracture and bipolar cautery on the compensatory inferior turbinate hypertrophy in septoplasty patients

IntroductionThe most common cause of septoplasty failure is inferior turbinate hypertrophy that is not treated properly. Several techniques have been described to date: total or partial turbinectomy, submucosal resection (surgical or with a microdebrider), with turbinate outfracture being some of those.ObjectiveIn this study, we compared the pre- and postoperative lower turbinate volumes using computed tomography in patients who had undergone septoplasty and compensatory lower turbinate turbinoplasty with those treated with outfracture and bipolar cauterization.MethodsThis retrospective study enrolled 66 patients (37 men, 29 women) who were admitted to our otorhinolaryngology clinic between 2010 and 2017 because of nasal obstruction and who were operated on for nasal septum deviation. The patients who underwent turbinoplasty due to compensatory lower turbinate hypertrophy were the turbinoplasty group; Outfracture and bipolar cauterization were separated as the out fracture group. Compensatory lower turbinate volumes of all patients participating in the study (mean age 34.0 ± 12.4 years, range 17–61 years) were assessed by preoperative and postoperative 2 month coronal and axial plane paranasal computed tomography.ResultsThe transverse and longitudinal dimensions of the postoperative turbinoplasty group were significantly lower than those of the out-fracture group (p = 0.004). In both groups the lower turbinate volumes were significantly decreased (p = 0.002, p < 0.001 in order). The postoperative volume of the turbinate on the deviated side of the patients was significantly increased: tubinoplasty group (p = 0.033).ConclusionBoth turbinoplasty and outfracture are effective volume-reduction techniques. However, the turbinoplasty method results in more reduction of the lower turbinate volume than outfracture and bipolar cauterization.