Systematically addressing nasal inferior turbinate surgical options

Ribeiro, João Carlos; Gonçalves, Joana; Carneiro, José

doi:10.1016/j.bjorl.2021.05.004

Cited by 1 publication

(2 citation statements)

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“…Securing patient follow-up can be challenging for any research group, and very few existing studies include more than one to two years of follow-up. Passali et al followed patients for up to six years, but 76% were lost by year six [ 18 ]. However, sufficient long-term follow-up is especially important for comparative outcomes, as this information can be used up front in technique selection to minimize the chance of recurrent hypertrophy and further procedures.…”

Section: Reviewmentioning

confidence: 99%

“…More recent studies are now available for inclusion in analysis. Multiple recent studies have reviewed many of the modern techniques for inferior turbinate hypertrophy surgical intervention [ 17 , 18 ]. This paper will expand upon these previous reviews of existing literature in order to highlight known outcomes, new technique developments, current deficiencies in the literature, and most importantly, to evaluate which methods could reduce transmission of SARS-CoV-2 and other airborne vectors.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management of Inferior Turbinate Hypertrophy in the Era of Widespread Communicable Disease

Smith¹,

Daines²,

Cazzaniga³

et al. 2023

Cureus

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Inferior turbinate reduction procedures have been performed for decades. After significant evolution, turbinoplasty and other mucosal-sparing techniques have become the main method to successfully reduce turbinate hypertrophy. The debate of which technique produces the most effective and durable outcomes is ongoing. During this critical era of widespread communicable diseases, including but not limited to COVID-19, HIV, and hepatitis, additional attention is necessary to balance outcomes with a degree of generation of airborne particles when selecting a technique. This review article aims to identify the optimal method for inferior turbinate reduction that weighs both outcomes and aerosol production. The MEDLINE database was searched to discover relevant publications through August 2022. Key search terms included inferior turbinate hypertrophy, turbinate reduction surgery, turbinoplasty methods, surgical management of turbinate hypertrophy, surgical aerosol generation, COVID-19 surgery, surgery smoke plume, SARS-CoV-2 transmission during surgery, and nasal procedures COVID-19 aerosols. Surgical management of the inferior turbinates includes radiofrequency ablation (RFA), microdebrider-assisted turbinoplasty (MAIT), electrocautery, laser, and ultrasound. Piezo-assisted turbinoplasty and a turbinate-specific coblation wand are new additions to the literature. All techniques appear to improve patient symptoms of nasal obstruction. MAIT and RFA are comparable, although MAIT demonstrated better long-term outcomes in some studies and appears to generate fewer airborne particles. Studies evaluating the production of aerosols due to RFA are lacking. Ultrasound outcomes are also excellent and generate no aerosols, but the technique has not been compared against the microdebrider. Electrocautery can result in increased pain and crusting for patients and causes the highest amount of aerosols. Deficiencies of current studies, including a lack of comparison of aerosol generation, duration of follow-up, omission of outfracture, and inadequate randomized controlled trials among existing and new techniques, have limited the identification of the best inferior turbinate reduction method. Given the durability of MAIT and its minimal aerosol production, it can be reinforced as the most sensible technique until further evidence is available.

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Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%