Comparação entre turbinoplastia e turbinectomia endoscópicas: eficácia e parâmetros clínicos

Abstract

RESUMOIntrodução: Obstrução nasal é um sintoma comum e atinge 25% da população. A hipertrofia de cornetos inferiores é a principal causa de obstrução nasal. Na falha do controle clínico um procedimento cirúrgico para redução do volume dos cornetos inferiores é indicado. Objetivo: Comparar a melhora da qualidade de vida no pósoperatório tardio de turbinectomia e turbinoplastia. Método: Estudo de Série de Casos retrospectivo. Foram avaliados 24 pacientes submetidos à cirurgia nasal de turbinectomia ou turbinoplastia em 2007. Os pacientes foram convocados para uma entrevista em agosto de 2008. Os pacientes foram avaliados quanto aos seguintes itens: escala NOSE pós-operatória, morbidade no PO, sangramentos e quantidade de crostas no PO. Resultados: Compareceram para a avaliação 24 pacientes. A principal variável analisada foi à diferença entre a escala NOSE no pré e no pós-operatório tardio. Não houve significância estatística pelo teste t de student nas variáveis estudadas. Discussão: Na avaliação dos diversos tipos de tratamento cirúrgico do corneto inferior a literatura mostra resultados semelhantes ao do nosso estudo encontrando resultados semelhantes entre as diversas técnicas cirúrgicas quanto à melhora da obstrução nasal e a atividade mucociliar. Conclusão: Não há evidencia na literatura e em nossa amostra da superioridade de uma técnica do tratamento cirúrgico do corneto inferior sobre os outros tratamentos. Palavras-chave: obstrução das vias respiratórias, obstrução nasal, rinite. SUMMARYIntroduction: Nasal Obstruction is a common symptom and affects 25% of the population. The inferior turbinate hypertrophy is the main cause of nasal obstruction. In the failure of clinical control, a surgical procedure to reduce the size of the inferior turbinate is indicated. Objective: Compare the improvement of life quality in late postoperative of Turbinectomy and turbinoplasty. Method: Study of a retrospective case series. 24 patients were submitted to a nasal surgery of turbinectomy or turbinoplasty in 2007. The patients were invited to an interview in august of 2008. The patients were evaluated in the following items: Postoperative NOSE scale, morbidity in postoperative, bleeding and quantity of crusts in postoperative. Results: 24 patients attended for the evaluation. The main variable analyzed was the difference between NOSE scales in late pre and post operative. There was no statistically significant by the test in the variables studied. Discussion: In the evaluation of the various types of surgical treatment of the inferior turbinate, literature shows similar results to our study, finding similar results between many surgical techniques in the improvement of the nasal obstruction and in mucociliary activity. Conclusion: There are no evidence in the literature and in our sample of the superiority of a technique of surgical treatment in the inferior turbinate under other treatments.

Benefits of Turbinectomy vs Turbinoplasty – A Prospective Study

“…The advantages, disadvantages, complications and controversies of each form of treatment have been reviewed and discussed by In our study, mean age was 33.17 years and 29.70 years in turbinectomy group and turbinoplasty group respectively with a slight male preponderance in both groups. These results are similar to the study done by Rodrigues et al 11 with mean age of 35.53 years in turbinectomy and 35.56 years in turbinoplasty group.…”

“…Mean pre-operative NOSE scores were 75.83 in turbinectomy group and 76.83 in turbinoplasty group which were similar to the study done by Rodrigues et al 11 with a mean value of 74 in turbinectomy group and 61.67 in turbinoplasty group. There was improvement in both turbinoplasty and turbinectomy group with a mean post-operative NOSE score of 11.77 and 35.50 respectively which is comparable to the study done by Rodrigues et al 11 with mean post-operative NOSE scores of 33.88 in turbinoplasty and 35.50 in turbinectomy group, but the improvement was slightly better in turbinoplasty group in our study. In the study done by Rodrigues et al 11 bleeding was slightly more in turbinoplasty group (33.3%) rather than turbinectomy (26.6%) group.…”

“…There was improvement in both turbinoplasty and turbinectomy group with a mean post-operative NOSE score of 11.77 and 35.50 respectively which is comparable to the study done by Rodrigues et al 11 with mean post-operative NOSE scores of 33.88 in turbinoplasty and 35.50 in turbinectomy group, but the improvement was slightly better in turbinoplasty group in our study. In the study done by Rodrigues et al 11 bleeding was slightly more in turbinoplasty group (33.3%) rather than turbinectomy (26.6%) group. But in our study bleeding was much less in the turbinoplasty group (3.3%) when compared to the turbinectomy group (10%).…”