Abstract
To study the long term outcome of endoscopic septoplasty with microdebrider assisted inferior turbinoplasty (MAIT) versus medial flap turbinoplasty (MFT). The present study was conducted in the Department of ENT, Government Medical College, Amritsar. Patients with symptomatic persistent nasal obstruction were recruited from ENT outdoor clinics. The nasal obstruction was persistent despite medical therapy that included a minimum 4 weeks. The study was primarily a double blinded prospective randomized control study including 120 patients, where all patients enrolled at odd numbers were taken for endoscopic septoplasty with microdebrider assisted inferior turbinoplasty and all patients with even numbers were taken for endoscopic septoplasty with MFT. Patient-scored nasal obstruction (1–5) along with blindly assessed nasal airway patency ratings (1–4) was done at 3 and 24 months postoperatively. A total of 120 patients were recruited in the study. The mean ages of the MAIT and MFT groups were 28.61 ± 14.8 and 30.25 ± 8.36 years, respectively. Average follow-up period was 21.9 ± 6.3 months. Nasal obstruction was improved in both techniques at 3 months, but after long term follow up, it was highly significant for MFT along with improvement in preoperative symptoms p < 0.001. No patients complained of worsening of their obstruction. Nasal patency at 24 months, a significant proportion of patients had a greater nasal assessment by a blind assessor with 97.1% in MFT and 81.9% MAIT with mild to no obstruction. In MAIT group 16.6% had pain/discomfort, 23.6% had discharge which were the major complications, but crusting (MAIT 10% and MFT 3.3%), adhesions (MAIT 13.8% and MFT 1.6%). The medial flap inferior turbinoplasty (MFT) is technically straight forward procedure that provides long term more effective and satisfactory the patient in relieving nasal obstruction, without significant risk of complications. The long term follow up of MAIT is required as there was increase in need of decongestion and they might require second procedure as MFT.
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References
Åkerlund A, Millqvist E, Öberg D, Bende M (2006) Prevalence of upper and lower airway symptoms: the Skövde population-based study. Acta Otolaryngol 126(5):483–488
Illum P (1997) Septoplasty and compensatory inferior turbinate hypertrophy: long-term results after randomized turbinoplasty. Eur Arch Otorhinolaryngol 254(1):S89–S92
Berger G, Hammel I, Berger R, Avraham S, Ophir D (2000) Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. The Laryngoscope 110(12):2100–2105
Rohrich RJ, Krueger JK, Adams JW, Marple BF (2001) Rationale for submucous resection of hypertrophied inferior turbinates in rhinoplasty: an evolution. Plast Reconstr Surg 108(2):536–544
Larrabee YC, Kacker A (2014) Which inferior turbinate reduction technique best decreases nasal obstruction? The Laryngoscope 124(4):814–815
Passàli D, Passàli FM, Passàli GC, Damiani V, Bellussi L (2003) Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 112(8):683–688
Huizing EH, De Groot JA (2003) Functional reconstructive nasal surgery, 943 illustrations & 23 tables. Thieme, New York
Bergmark RW, Gray ST (2018) Surgical management of turbinate hypertrophy. Otolaryngol Clin N Am 51(5):919–928
Ikeda K, Oshima T, Suzuki M, Suzuki H, Shimomura A (2006) Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis. Acta Otolaryngol 126(7):739–745
Van Delden MR, Cook PR, Davis WE (1999) Endoscopic partial inferior turbinoplasty. Otolaryngol Head Neck Surg 121(4):406–409
Al-Reefy H, Hopkins C (2013) Endoscopic assisted modified turbinoplasty with mucosal flap. J Laryngol Otol 127(7):728
Nunez DA, Bradley PJ (2000) A randomised clinical trial of turbinectomy for compensatory turbinate hypertrophy in patients with anterior septal deviations. Clin Otolaryngol Allied Sci 25(6):495–498
Yáñez C (1998) New technique for turbinate reduction in chronic hypertrophic rhinitis: intraturbinate stroma removal using the microdebrider. Oper Tech Otolaryngol Head Neck Surg 9(3):135–137
Puterman M, Segal N, Joshua B (2012) Endoscopic, assisted, modified turbinoplasty with mucosal flap. J Laryngol Otol 126(5):525–528. https://doi.org/10.1017/S0022215112000163
Barham HP, Thornton MA, Knisley A, Marcells GN, Harvey RJ, Sacks R (2016) Long-term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction. Int Forum Allergy Rhinol 6:143–147
Cingi C, Ure B, Cakli H, Ozudogru E (2010) Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty: a prospective study with objective and subjective outcome measures. Acta Otorhinolaryngol Ital 30(3):138
Gupta A, Mercurio E, Bielamowicz S (2001) Endoscopic inferior turbinate reduction: an outcomes analysis. The Laryngoscope 111(11):1957–1959
Davis WE, Nishioka GJ (1996) Endoscopic partial inferior turbinectomy using a power microcutting instrument. J ENT 75:49–50
Lee CF, Chen TA (2004) Power microdebrider-assisted modification of endoscopic inferior turbinoplasty: a preliminary report. Chang Gung Med J 27(5):359–365
Chen YL, Tan CT, Huang HM (2018) Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope 118(7):1270–1274
Neri G, Mastronardi V, Traini T, D’Orazio F, Pugliese M, Cazzato F (2013) Respecting nasal mucosa during turbinate surgery: end of the dogma? Rhinology 51(4):368–375
Wormald PJ (2013) Powered inferior turbinoplasty and endoscopic septoplasty, Chap. 4. In: Al-Helo S, Falih H, Jumma A (eds) Endoscopic sinus surgery: anatomy, three-dimensional reconstruction, and surgical technique, 3rd edn. Thieme, New York, pp 19–27
Kassab NA, Rifaat M, Madian Y (2012) Comparative study of management of inferior turbinate hypertrophy using turbinoplasty assisted by microdebrider or 980 nm diode laser. J Laryngol Otol 126:1231–1237
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Sandhu, K.S., Singh, S.P., Thomas, O. et al. To Study the Long Term Outcome of Endoscopic Septoplasty with Microdebrider Assisted Inferior Turbinoplasty (MAIT) Versus Medial Flap Turbinoplasty (MFT). Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 863–869 (2022). https://doi.org/10.1007/s12070-020-01936-4
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DOI: https://doi.org/10.1007/s12070-020-01936-4