Inferior Turbinate Hypertrophy: A Comparison of Surgical Techniques

Abstract

IntroductionNasal obstruction is one of the most frequently reported symptoms in clinical practice. The second most common cause of nasal obstruction is inferior turbinate hypertrophy, a nasal pathology for which surgical treatment is often required. This study aims to determine the most effective surgical method in patients with inferior turbinate hypertrophy (ITH). Materials and methodsThe study was performed from September 2018 to October 2019 in the Otolaryngology-Head and Neck Surgery Department of the Evangelismos Hospital of Athens. The study population comprised 205 patients that underwent surgery and were monitored in the hospital. Radiofrequency ablation (RFA) was the method used in 73 patients, 68 patients were treated with the microdebrider-assisted turbinoplasty (MAT), and the remaining 64 patients were operated on using electrocautery (EC). Following surgery, postoperative complications were assessed and quantified. ResultsOverall, 205 patients underwent surgery. The first group (n=73) was operated on using radiofrequency ablation and had a complication rate of 30.1%. Out of 73 patients, 51 recovered without complications. The remaining 22 had complications, consisting of 16 patients with bleeding and six with postnasal drip.The second group (n=68) was treated using the microdebrider method. The complication rate was 26.5%, where 50 patients did not present with any symptoms post-operatively and 18 exhibited symptoms. Specifically, postnasal drip was more prevalent with this method as all 18 patients showed postnasal drip as their complication.The third group (n=64) was treated with electrocautery. Patients in this group had the most complications (n=24), 16 were attributed to postnasal drip and eight to infections, treated promptly with oral antibiotics. The complication rate using this method was 37.5%. ConclusionIn our study, the microdebrider-assisted turbinoplasty offered the lowest complication rate, followed by radiofrequency ablation and electrocautery. However, all three methods managed to alleviate the nasal obstruction and treat inferior turbinate hypertrophy. More research is needed as a lack of consensus remains regarding the optimal surgical technique for lower turbinate hypertrophy.

Comparison of the post-operative outcomes between different surgical techniques for inferior turbinate reduction surgery

“…When comparing our results with the existing literature on surgical treatment for ITH, we find alignment with certain studies while observing variations in outcomes based on specific surgical techniques. 9 , 12 , 14 - 18 Iqbal et al 14 for example, reported a similar trend to our findings in 2017, with most patients experiencing improvement in the first weeks postoperatively and a further increase in the number of patients showing improvement after three months. This similarity underscores the importance of carrying out multiple fixed clinical encounters to accurately assess patient clinical improvement, as we recommended in our study.…”

“…The study of Karamatzanis et al 9 confirms our conclusion that microdebrider-assisted turbinoplasty provides lower complications than other surgical techniques. This indicates that using a microdebrider may increase safety and better patient outcomes in inferior turbinate reduction surgery.…”

“…1,5,6 Different surgical techniques have been utilized to treat ITH, including submucosal diathermy, partial inferior turbinectomy, powered turbinectomy, and radiofrequency ablation. 1,[5][6][7][8][9][10][11][12] As a result, numerous studies have been published comparing the outcomes of various surgical techniques for inferior turbinate reduction. In a comprehensive study by Levy et al 12 in 2022, they thoroughly examined 1035 patients who had undergone different surgical techniques for treating ITH.…”