Long‐term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction

Barham, Henry P.; Thornton, Mona; Knisely, Anna; Marcells, George N.; Harvey, Richard J.; Sacks, Raymond

doi:10.1002/alr.21574

Cited by 27 publications

(24 citation statements)

References 11 publications

(10 reference statements)

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“…Cingi et al, Chieh-Feng et al, Albu et al, all of them reported that gradual decrement in postoperative pain and no patient had pain at 1 and 3 months following the surgery and this was comparable to our study. 20,30,32 No synechiae was reported during the follow up period after surgery, this might be due to placement of surgicel and silastic sheets (no raw area), and this agreed with Cingi et al, Hesham et al 10,20 No epiphora was observed from the 1 st week to the 3 rd month following the surgery, this might correlated with Barham et al, Hesham et al 10,33 …”

Section: Post-operative Complicationssupporting

confidence: 59%

Powered endoscopic inferior turbinoplasty: clinical study

Al-Helo

Falih²,

Jumma³

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Nasal obstruction is a common complaint in ENT clinics and significantly affect the patient`s quality of life. Inferior turbinate hypertrophy is one of the common causes of nasal obstruction, surgical reduction of inferior turbinate is indicated in refractory cases not responding to conservative measures and the optimal surgical technique is controversial. The aim of the study was to evaluate the clinical outcomes of powered endoscopic inferior turbinoplasty in the management of inferior turbinate hypertrophy. Methods: An interventional study (single group clinical trial) was conducted and powered endoscopic inferior turbinoplasty was performed on 30 patients complaining of chronic nasal obstruction due to inferior turbinate hypertrophy and other causes of nasal obstruction were excluded. Results: Assessed preoperatively and 1st week, 1st month and 3rd month postoperatively depending on subjective visual analogue scale scores for nasal obstruction, endoscopic grading system and complications. There was significant improvement in nasal obstruction and significant reduction in inferior turbinate size and mild complications that completely absent at the third month following the surgery. Conclusions: Microdebrider-assisted inferior turbinoplasty as a safe, effective and reliable alternative method for inferior turbinate reduction.

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Section: Post-operative Complicationssupporting

confidence: 59%

Powered endoscopic inferior turbinoplasty: clinical study

Al-Helo

Falih²,

Jumma³

2017

Int J Otorhinolaryngol Head Neck Surg

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“…Existing studies of microdebrider‐assisted submucosal resection report increased rhinomanometric nasal airflow, decreased nasal airway resistance, and greater improvement in patient‐determined nasal obstruction compared to preoperative or healthy controls . Other studies suggest longer efficacy for medial flap turbinoplasty beginning between 12 and 24 months, with lower reported revision rates (12%) compared to electrocautery (54%) or powered submucosal resection (i.e., microdebrider; 40%) during 60‐month follow‐up (n = 100) . These studies are limited by the lack of standardized outcomes, with measures based on rhinomanometry and acoustic rhinometry of unclear clinical significance given the lack of established correlation with PROMs .…”

Section: Discussionmentioning

confidence: 99%

Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery

et al. 2019

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Objectives: To evaluate the long-term impact of functional septorhinoplasty (SRP) with and without inferior turbinate reduction (ITR) on disease-specific symptom severity and general health-related quality of life (QOL).Study Design: Prospective cohort study at a tertiary referral center. Methods: Patients undergoing functional SRP with and without ITR were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale to assess severity of nasal obstruction and the EuroQol-5 Dimension Questionnaire Visual Analog Scale (EQ-5D VAS) to assess general health-related QOL preoperatively and at 2, 4, 6, 12, 24, and 36 months postoperatively. Patient demographics, surgical technique, symptom severity, and QOL outcomes were analyzed.Results: A total of 567 patients were included, with 391 patients undergoing functional SRP alone (54.0% female; mean age 36.0 years [standard deviation (SD):16.2]) and 176 patients undergoing functional SRP with ITR (50.0% female; mean age 35.6 years [SD:13.6]). There was a significant decrease in NOSE and increase in EQ-5D VAS scores in both groups through at least 24 months postoperatively. Change in NOSE scores was negatively correlated with change in EQ-5D VAS (r = −0.38, P < 0.01). Compared to patients undergoing SRP, patients also undergoing ITR had a statistically but nonclinically significant improvement in NOSE, with similar trends for EQ-5D VAS that were not significant.Conclusion: SRP results in a sustained, long-term improvement in nasal obstruction based on disease-specific and general health-related QOL measures, with incremental improvement in outcomes with addition of ITR. This study provides the foundation for defining health outcomes and the health utility value of surgical interventions that address nasal obstruction.

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“…To perform fine surgical maneuvers underwater, surgeons must perform fine manipulations in the narrow nasal space, which resembles a small pocket, while avoiding tears in the IT mucosa. Second, SIT may lead to atrophic rhinitis; however, this complication has not been reported in two articles evaluating the long-term results of SIT (6, 7). Similarly, we have not experienced atrophic rhinitis in our cases.…”

Section: Discussionmentioning

confidence: 99%

Submucosal Inferior Turbinoplasty Using a New Continuous Suction Irrigation Method

Kanaya

Kohno

2017

Front. Surg.

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IntroductionNumerous surgical techniques for inferior turbinate hypertrophy (ITH) have been reported, each with advantages and disadvantages. Submucosal turbinoplasty with removal of the bony component of the inferior turbinate (IT) is an excellent procedure to expand the nasal cavity. However, this procedure requires a large incision to remove the inferior turbinate bone (ITB) and is associated with hemorrhage, crust formation, and adhesion. A smaller incision would avoid such complications. We developed a continuous suction irrigation method that maintains a clear view of the limited surgical field of the IT. Only a single small incision is needed to insert the rigid endoscope. The surgeon can flush blood with continuous water flow and perform IT surgery without difficulty. We performed this method in 39 cases from January 2016 to January 2017. This video article demonstrates our new submucosal inferior turbinoplasty technique.MethodsSubmucosal turbinoplasty using a continuous suction irrigation method was performed under general anesthesia. An irrigation-suction straw sheath system was used to create an underwater surgical field.ResultsThe ITB was removed safely with no severe complications. An expanded common nasal cavity was confirmed postoperatively on computed tomographic images.ConclusionWe resected the ITB safely using a continuous suction irrigation method without difficulty or complications. We believe that this method may become one of the best surgical options for ITH.

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Long‐term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction

Abstract: The medial flap turbinoplasty provided consistent, robust results. Long-term relief of obstructive symptoms without additional risk of complication was observed in the turbinoplasty group.

Cited by 27 publications

References 11 publications

Powered endoscopic inferior turbinoplasty: clinical study

Powered endoscopic inferior turbinoplasty: clinical study

Improvement in nasal obstruction and quality of life after septorhinoplasty and turbinate surgery

Submucosal Inferior Turbinoplasty Using a New Continuous Suction Irrigation Method

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