Comparative study between diathermy and microdebrider for inferior turbinate reduction surgeries

Abstract

Background:Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication.Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion:To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.

Medical vs Surgical Treatment for Symptomatic Enlarged Inferior Turbinate: A Comparative Study

“…[9][10][11] The age of patients studied ranged 15 -55 years with mean age of 33.47± 9.57 years that is comparable with results of Chavanwho divided the patients in two groups and in one group patient mean age was 29.48 years while in other group mean age was 28.28 years. 12 Similarly in a Turkish study mean age of the patients was 32.16 ± 10.48 years (range 20-59 years). 13 The reason is that the 3 rd and 4 th decade is the most active time of life, one can be affected easily by environmental hazards and seeks asolution on apriority basis to eliminateany health issues.…”

Systematic Review of Surgical Interventions for Inferior Turbinate Hypertrophy

“…13 With RFA or submucosal diathermy, scar tissue develops in the submucosal layer causing damage to the vascular and glandular structures leading to fibrosis, prevention of regrowth, and a reduced amount of IgE and eosinophils present on the nasal mucosa. 13,14 Additionally, relief in AR and NAR might be attributed to the destruction of branches of posterior nasal nerve, which plays an important role in sneezing and hypersecretion. 15 No statistical significance was observed when stratifying outcomes by AR and NAR groups, suggesting that the effectiveness of RFA in improving nasal obstruction is similar for both patient populations.…”

Rhinology in review: from COVID-19 to biologicals

“…For the diagnosis of CR it is important to exclude other diseases involving the nose and sinuses like CRS, septal deviation (69) and other anatomical changes like turbinate hypertrophy (69)(70)(71)(72)(73) and even OSAS (74,75) . Although this may be obvious, in the last year COVID-19 has shown us how difficult it can be for patients with CR or CRS and their surroundings to discriminate their daily symptoms from concomitant conditions like COVID-19 (76) .…”