Objectives:
• To study the role of endoscopic and microdebrider-assisted partial inferior turbinectomy in inferior turbinate hypertrophy.
• To study the improvement in symptoms and quality of life following the procedure.
• To study the complications of endoscopic and microdebrider-assisted partial inferior turbinectomy.
Materials and methods: A prospective study was conducted on 50 subjects over a period of 18 months. Subjects who presented with long-standing nasal obstruction secondary to hypertrophy of inferior turbinate also not responding to medical therapy were enrolled for the study. They were taken up for endoscopic microdebrider-assisted partial inferior turbinectomy. Saccharine transit test and modified spirometry were done and modified SNOT 10 questionnaire was administered preoperatively as well as in the 1st and 3rd postoperative months.
Results: On subjective assessment using SNOT 10 Questionnaire, it was seen that patients with headache, nasal obstruction, and anosmia had the highest benefit post-surgery. Out of 50 subjects reported with nasal obstruction preoperatively, only 16 had mild obstruction in the 3rd postoperative month which was statistically significant. Of 44 subjects with headache, only 17 had mild headache in the 3rd postoperative month. Only 8 of 43 subjects with anosmia still had mild symptoms during the 3rd month. On objective assessment using saccharine transit test, the mean time of 16.02 preoperatively decreased to 14.32 at 3 months after surgery. The rhinospirometry also showed a statistically significant improvement, 3 months after surgery when compared with preoperative values.
Conclusion: Endoscopic and microdebrider-assisted partial inferior turbinectomy proved to be a safe and one of the most effective treatments for chronic nasal obstruction secondary to inferior turbinate hypertrophy. The SNOT 10 questionnaire is an effective tool in the subjective assessment of patients undergoing partial inferior turbinectomy.
Clinical significance: Symptomatic inferior turbinate hypertrophy can be effectively treated by endoscopic and microdebrider-assisted partial inferior turbinectomy and the SNOT 10 questionnaire may act as an indicator.
Huang TW, Cheng PW. Changes in nasal resistance and quality of life after endoscopic microdebrider-assisted inferior turbinoplasty in patients with perennial allergic rhinitis. Arch Otolaryngol Head Neck Surg 2006;132(9):990–993. DOI: 10.1001/archotol.132.9.990.
Chen YL, Tan CT, Huang HM. Long term efficacy of microdebrider assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbiantes in patients with perennial allergic rhinitis. The Laryngoscope 2008;118(7):1270–1274. DOI: 10.1097/MLG. 0b013e31816d728e.
Nathan RA, Eccles R, Howarth PH, et al. Objective monitoring of nasal patency and nasal physiology in rhinitis. J Allergy Clin Immunol 2005;115(3):442–459. DOI: 10.1016/j.jaci.2004.12.015.
Cuddihy PJ, Eccles R. The use of nasal spirometry as an objective measure of nasal septal deviation and the effectiveness of septal surgery. Clin Otolaryngol Allied Sci 2003;28(4):325–330. DOI: 10.1046/j.1365-2273.2003.00714.x.
Nagle SK, Kelkar RS. Spirometry as an objective tool for nasal patency. Ind J Otolaryngol Head Neck Surg 2007;59(1):41–42. DOI: 10.1007/s12070-007-0010-9.
Piatti G, Scotti A, Ambrosetti U. Nasal ciliary beat after insertion of septo-valvular splints. Otolaryngol Head Neck Surg 2004;130(5): 558–562. DOI: 10.1016/j.otohns.2003.07.013.
Singh M, Chandra M, Gupta SC, et al. Role of measurement nasal mucociliary clearance by saccharine test as a yard stick of success of functional endoscopic sinus surgery. Indian J Otolaryngol Head Neck Surg 2010;62(3):289–295. DOI: 10.1007/s12070-010-0074-9.
Asai K, Haruna S, Otori N, et al. Saccharin test of maxillary sinus mucociliary function after endoscopic sinus surgery. Laryngoscope 2000;110(1):117–122. DOI: 10.1097/00005537-200001000-00021.
Unsal O, Ozkahraman M, Ozkarafakili MA, et al. Does the reduction of inferior turbinate affect lower airway functions? Braz J Otorhinolaryngol 2019;85(1):43–49.
Sapci T, Sahin B, Karavus A, et al. Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 2003;113(3):514–519. DOI: 10.1097/00005537-20030 3000-00022.
Ohashi Y, Nakai Y, Ikeoka H, et al. Regeneration of nasal mucosa following mechanical injury. Acta Otolaryngol Suppl 1991;486: 193–201. DOI: 10.3109/00016489109134996.
Sakallıoğlu Ö, Düzer S, Kapusuz Z, et al. The evaluation of nasal mucociliary activity after septoplasty and external septorhinoplasty. Indian J Otolaryngol Head Neck Surg 2013;65(S2):360–365. DOI: 10.1007/s12070-012-0532-7
Rai S, Sharma V, Koirala KP, et al. Endoscopic versus conventional method for partial inferior turbinectomy in chronic hypertrophic rhinitis. Nepal Journal of Medical Sciences 2013;2(2):102–107. DOI: 10.3126/njms.v2i2.8945.
Elwany S, Harrison R. Inferior turbinectomy: comparison of four techniques. The J Laryngol Otol 1990;104(3):206–209. DOI: 10.1017/s0022215100112290.
Damm M, Eckel HE, Jungehülsing M, et al. Olfactory changes at threshold and suprathreshold levels following septoplasty with partial inferior turbinectomy. Ann Otol, Rhinol & Laryngol 2003;112(1):91–97. DOI: 10.1177/000348940311200117.
Mathai J. Inferior turbinectomy for nasal obstruction review of 75 cases. Indian J Otolaryngol Head Neck Surg 2004;56(1):23–26. DOI: 10.1007/BF02968766.
Rakover Y, Rosen G. A comparison of partial inferior turbinectomy and cryosurgery for hypertrophic inferior turbinates. J Laryngol Otol 1996;110(8):732–735. DOI: 10.1017/s0022215100134826.