The evidence for reducing inferior turbinates

Willatt, David

doi:10.4193/rhin09.017

Cited by 53 publications

(71 citation statements)

References 74 publications

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“…It has similar, if not better, long-term symptom relief than other common surgical treatments such as turbinectomy, submucosal turbinectomy, microdebrider submucosal resection, cryotherapy, submucous electrosurgery, and laser turbinectomy [7]. There were no significant complications and minimal morbidity (rebound congestion for shorter than 5 days in 64% of the patients) in our study as compatible with the published series to date [7][8][9].…”

Section: Discussionsupporting

confidence: 88%

“…At this point of persistent symptoms, medical management usually fails and the grounds for surgical reduction are laid down [9].…”

Section: Discussionmentioning

confidence: 99%

“…Various medical and surgical procedures have been employed to treat turbinate hypertrophy caused by various etiologies [6][7][8][9]. Clinical data have shown intranasal steroids (INS) to be the most potent medications available for symptom relief.…”

Section: Introductionmentioning

confidence: 99%

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Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters

Günhan

Ünlü

Yücetürk

et al. 2010

Eur Arch Otorhinolaryngol

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Nasal congestion is a cardinal symptom of allergic rhinitis (AR). It is associated with decreased quality of life and difficult to treat as perceived by the patients. The purpose of this study is to evaluate the mid-term objective and subjective outcomes of management of nasal congestion using intranasal steroid (INS) therapy or radiofrequency turbinoplasty (RFT) in patients with persistent AR who have mucosal hypertrophy of the inferior turbinate. Fifty-five adult patients with AR, who claimed nasal congestion refractory to oral antihistamine (desloratadine) therapy, were randomized to INS (mometasone furoate) or temperature-controlled RFT treatment groups. Outcomes were determined by active anterior rhinomanometry, visual analog scale (VAS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) at least 12 months after treatment. The median total nasal resistance decreased from 0.49 ± 0.17 to 0.39 ± 0.12 Pa/cm(3)/s (p = 0.42), and from 0.51 ± 0.18 to 0.29 ± 0.07 Pa/cm(3)/s (p = 0.003) with INS and RFT, respectively. RFT provided a better reduction in the perception of congestion in VAS scores. RQLQ scores improved significantly in both groups 1 year after treatment (mean follow-up 14.2 months) (p < 0.05). No adverse reactions were encountered in either group. Nasal congestion refractory to antihistamine appears to be improved by INS at some point, while reduced significantly by RFT in objective and subjective parameters. Both options are also effective in increasing the quality of life in patients with AR. RFT might be a safe and effective treatment of option in AR compared with INS.

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Section: Discussionsupporting

confidence: 88%

“…At this point of persistent symptoms, medical management usually fails and the grounds for surgical reduction are laid down [9].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters

Günhan

Ünlü

Yücetürk

et al. 2010

Eur Arch Otorhinolaryngol

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“…Of the three turbinates, the inferior turbinate is most susceptible to hypertrophy. ITH can be bilateral or unilateral, and the bilateral variety can be due to hypertrophy from allergic or nonallergic rhinitis [2]. Enlargement of the erectile mucosa of the inferior turbinate significantly increases nasal airway resistance, contributing greatly to symptoms of nasal airway obstruction [10].…”

Section: Discussionmentioning

confidence: 99%

“…NSD towards one side is often associated with an overgrowth of the inferior turbinate, which occupies the expansive space of the contralateral nasal cavity [2]. It has been assumed that this counterbalanced mechanism, characterized by compensatory mucosal hypertrophy, serves to protect the more patent nasal side from excess airflow, which causes drying and crusting.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Mesenchymal Stem Cells Originating from the Bilateral Inferior Turbinate in Humans with Nasal Septal Deviation

et al. 2014

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Background and objectivesNasal septal deviation (NSD) is often associated with overgrowth of the unilateral inferior turbinate. In vivo and in vitro studies indicate that human mesenchymal stem cells (MSCs) are able to differentiate into multiple cell types, including osteoblasts. We tested the hypothesis that turbinate size affects human turbinate-derived MSC (hTMSCs) quantity, proliferation, and differentiation into osteogenic lineages, and that hypertrophic turbinates may predispose to NSD on the contralateral side.Subjects and MethodsThe hypertrophic and contralateral inferior turbinate tissues used in our study were obtained and cultured from the tissue discarded from 10 patients who underwent septoplasty and partial turbinectomy. After isolating the hTMSCs from both turbinates, the cells were enumerated using an automated cell counter. The expression of surface markers for MSCs over four passages was assessed by fluorescent-activated cell sorting analysis (FACS), and cell proliferation was assessed using a cell counting kit (CCK)-8 according to turbinate size. In addition, osteogenic differentiation of hTMSCs was identified using alkaline phosphatase (ALP) and alizarin red S staining, after which osteoblastic gene expression was evaluated.ResultsThere was no significant difference in the number of hTMSCs. FACS analysis revealed that the hTMSCs were negative for CD14, CD19, CD34, and HLA-DR, and positive for CD29, CD73, and CD90, representing a characteristic MSC phenotype, with no significant difference between the two groups. The cellular proliferation and osteogenic differentiation potential of the hTMSCs were also not significantly different between the two groups.ConclusionsWe conclude that turbinate size does not affect the characterization, proliferation, and osteogenic differentiation potential of hTMSCs in vitro test, and therefore should not affect the clinical decision of whether to use autologous or allogenic hTMSCs. However, more experiments are required to definitively state the relationship of hTMSCs with turbinate size or the process NSD in humans.

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Correlation of Nasal Mucosal Temperature With Subjective Nasal Patency in Healthy Individuals

Bailey

Casey

Pawar

et al. 2017

JAMA Facial Plast Surg

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Importance-Historically, otolaryngologists have focused on nasal resistance to airflow and minimum airspace cross-sectional area as objective measures of nasal obstruction using methods such as rhinomanometry and acoustic rhinometry. However, subjective sensation of nasal patency may be more associated with activation of cold receptors by inspired air than with respiratory effort.Objective-To investigate whether subjective nasal patency correlates with nasal mucosal temperature in healthy subjects.Design, Setting, and Participants-Twenty-two healthy adults were recruited for this study. Subjects first completed the Nasal Obstruction Symptom Evaluation (NOSE) and a unilateral visual analog scale (VAS) to quantify subjective nasal patency. A miniaturized thermocouple sensor was then used to record nasal mucosal temperature bilaterally in two locations along the nasal septum: at the vestibule and across from the inferior turbinate head.Results-The range of temperature oscillations during the breathing cycle, defined as the difference between end-expiratory and end-inspiratory temperatures, was greater during deep breaths (ΔT exp-insp = 6.2 ± 2.6°C) than during resting breathing (ΔT exp-insp = 4.2 ± 2.3°C) in both locations (p < 10 −13 ). Mucosal temperature measured at the right vestibule had a statistically significant correlation with both right-side VAS score (Pearson r = −0.55, p=0.0076) and NOSE

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The evidence for reducing inferior turbinates

Cited by 53 publications

References 74 publications

Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters

Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters

Characteristics of Mesenchymal Stem Cells Originating from the Bilateral Inferior Turbinate in Humans with Nasal Septal Deviation

Correlation of Nasal Mucosal Temperature With Subjective Nasal Patency in Healthy Individuals

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