Inferior Turbinate Reduction Methods: A Comparative Study

Abstract

Background: Inferior turbinate is an important structure in nasal physiology. It plays a role in various functions like filtration, warming, humidification of air and modifying nasal airway resistance. Turbinate hypertrophy either due to allergic or non allergic causes is a common cause of nasal obstruction. Though various conservative methods have been used like intranasal sprays, antihistamines, systemic decongestants, mast cell stabilizers and allergic desensitization , these means usually lead only to slight improvement and surgical reduction of the inferior turbinates  is the most effective treatment. Objectives: To compare the efficacy of 4 different techniques i.e turbinoplasty, partial turbinectomy, complete turbinectomy and cauterization in management of inferior turbinate hypertrophy. Methodology: This is a prospective and comparative study with 100 patients conducted between September 2017 to March 2020, in the Department of Otorhinolaryngology, Bangalore medical college and research institute. Results: Our study included (68%) males and (32%) females. The mean age of the patient was reported to be 31.5 years.On follow up the mean reduction in postoperative nasal obstruction  was found to be 53.40 ± 3.45 in first week and 14.40 ± 3.90 on third month using turbinoplasty, and 64.00 ± 2.88 on first week and 40.00 ± 4.08 third month respectively using partial turbinectomy; and 41.60 ± 3.74 and 24.60 ± 3.51 on first week and third month respectively by complete turbinectomy; 67.80 ± 2.53 and on first week and 28.80 ± 3.61 third month respectively by monopolar cautery. Postoperative complications like postoperative pain, post-operative bleeding and crusting was more in complete turbinectomy than compared to other procedures. Conclusion: Surgical reduction of the inferior turbinates is an effective treatment modality for patients with chronic nasal obstruction due to inferior turbinate enlargement.  In our study we have compared 4 different techniques : turbinoplasty, partial turbinectomy, complete turbinectomy and monopolar cautery.  Each technique has its own advantages and disadvantages. But on comparing the postoperative outcomes, turbinoplasty is found to be a safe and better technique in reducing inferior turbinate size reduction by preserving mucosal surface hence preserving physiologic function and lowering crust formation.

Keywords: Turbinoplasty, Partial turbinectomy, Complete Turbinectomy, Monopolar cautery