Microdebrider-assisted Inferior Turbinectomy: Improving Quality of Life in Patients with Nasal Allergy
Sumitha Ramanathan, Nisha A Joseph
Citation Information :
Ramanathan S, Joseph NA. Microdebrider-assisted Inferior Turbinectomy: Improving Quality of Life in Patients with Nasal Allergy. Int J Otorhinolaryngol Clin 2017; 9 (2):39-41.
Objective: To assess the effectiveness of resection of inferior turbinate with assisted powered instrumentation in patients with nasal allergy.
Study design: A total of 50 patients presenting to the outpatient Department of Otorhinolaryngology in Sree Balaji Medical College & Hospital, Chennai, India, with nasal allergy with turbinate hypertrophy on examination between the age of 19 to 45 years were included in the study during the period between December 2014 and July 2015.
Materials and methods: All patients were assessed subjectively by a questionnaire regarding their symptoms and objectively graded by the size of turbinate hypertrophy as grades I, II, and III. Patients with grade II and III turbinate hypertrophy were subjected to inferior turbinectomy using microdebrider and followed up for postoperative outcome and any complications.
Results: The advantage of the microdebrider technique is the precise control of the amount of tissue and location of tissue, i.e., removed on a submucosal plane. There are very less complications. There was no crusting or excessive bleeding during the procedure.
Conclusion: The results show that submucous resection of inferior turbinates with a microdebrider is a safe method of achieving turbinate size reduction with minimal morbidity.
Bridger GP, Proctor DF. Maximum nasal inspiratory flow and nasal resistance. Ann Otol Rhinol Laryngol 1970 Jun;79(3):481-488.
Kimmelman CP, Ali GH. Vasomotor rhinitis. Otolaryngol Clin North Am 1986 Feb;19(1):65-71.
Martinez SA, Nissen AJ, Stock CR, Tesmer T. Nasal turbinate resection for relief of nasal obstruction. Laryngoscope 1983 Jul;93(7):871-875.
Pollock RA, Rohrich FLJ. Inferior turbinate surgery: an adjunct to successful treatment of nasal obstruction in 408 patients. Plast Reconstr Surg 1984 Aug;74(2):227-236.
Ophir D, Shapira A, Marshak G. Total inferior turbinectomy for nasal airway obstruction. Arch Otolaryngol 1985 Feb;111(2):93-95.
Salam MA, Wengraf C. Concho-antropexy or total inferior turbinectomy for hypertrophy of the inferior turbinates? A prospective randomized study. J Laryngol Otol 1993 Dec;107(12):1125-1128.
Williams HO, Fisher EW, Golding-Wood DG. Two-stage turbinectomy: sequestration of the inferior turbinate following submucosal diathermy. J Laryngol Otol 1991 Jan;105(1):14-16.
Dawes PJ. The early complications of inferior turbinectomy. J Laryngol Otol 1987 Nov;101(11):1136-1139.
Elwany S, Harrison R. Inferior turbinectomy: comparison of four techniques. J Laryngol Otol 1990 Mar;104(3):206-209.
Lippert BM, Werner JA. CO2 laser surgery of hypertrophied inferior turbinates. Rhinology 1997 Mar;35(1):33-36.
Killey HC, Kay LW. The impacted wisdom tooth. London: E&S Livingstone Ltd.; 1965.
Obimakinde OS, Akinpelu AM, Obimakinde AM. Risk indicators of operative difficulty of impacted mandibular third molar in a Nigerian Tertiary Hospital. Open Access Sci Rep 2012 Sep;1(7):354.
Renton T, Smeeton N, McGurk M. Factors predictive of difficulty of mandibular third molar surgery. Br Dent J 2001 Jun;190(11):607-610.
Gbotolorun OM, Arotiba GT, Ladeinde AL. Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. J Oral Maxillofac Surg 2007 Oct;65(10):1977-1983.
Carvalho RW, do Egito Vasconcelos BC. Assessment of factors associated with surgical difficulty during removal of impacted lower third molars. J Oral Maxillofac Surg 2011 Nov;69(11):2714-2721.
Akadiri OA, Obiechina AE. Assessment of difficulty in third molar surgery—a systematic review. J Oral Maxillofac Surg 2009 Apr;67(4):771-774.
Chandler LP, Laskin DM. Accuracy of radiographs in classification of impacted third molar teeth. J Oral Maxillofac Surg 1988 Aug;46(8):656-660.
Bello SA, Adeyemo WL, Bamqbose BO, Obi EV, Adeyinka AA. Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery. Head Face Med 2011 Apr;7:8.
Susarla SM, Dodson TB. Estimating third molar extraction difficulty: a comparison of subjective and objective factors. J Oral Maxillofac Surg 2005 Apr;63(4):427-434.
Nakagawa Y, Ishii H, Nomura Y, Watanabe NY, Hoshiba D, Kobayashi K, Ishibashi K. Third molar position: reliability of panoramic radiography. J Oral Maxillofac Surg 2007 Jul;65(7):1303-1308.
García AG, Sampedro FG, Rey JG, Vila PG, Martin MS. Pell-Gregory classification is unreliable as a predictor of difficulty in extracting impacted lower third molars. Br J Oral Maxillofac Surg 2000 Dec;38(6):585-587.
Gomes VL, Gonçalves LC, do Prado CJ, Junior IL, de Lima Lucas B. Correlation between facial measurements and the mesiodistal width of the maxillary anterior teeth. J Esthet Restor Dent 2006;18(4):196-205.
Varjão FM, Nogueira SS. Intercommissural width in 4 racial groups as a guide for the selection of maxillary anterior teeth in complete dentures. Int J Prosthodont 2005 Nov-Dec;18(6):513-515.
Abdullah MA. Inner canthal distance and geometric progression as a predictor of maxillary central incisor width. J Prosthet Dent 2002 Jul;88(1):16-20.
Al Wazzan KA. The relationship between intercanthal dimension and the widths of maxillary anterior teeth. J Prosthet Dent 2001 Dec;86(6):608-612.
al-el-Sheikh HM, al-Athel MS. The relationship of interalar width, interpupillary width and maxillary anterior teeth width in Saudi population. Odontostomatol Trop 1998 Dec;21(84):7-10.
Dharap AS, Tanuseputro H. A comparison of interalar width and intercanine distance in Malay males and females. Anthropol Anz 1997 Mar;55(1):63-68.
Hoffman W Jr, Bomberg TJ, Hatch RA. Interalar width as a guide in denture tooth selection. J Prosthet Dent 1986 Feb;55(2):219-221.
Gómez-Moreno G, Fernández-Cejas E, Aguilar-Salvatierra A, de Carlos F, Delgado-Ruiz RA, Calvo-Guirado JL. Dental implant surgery in patients in treatment by dabigatran. Clin Oral Implants Res 2016 Jan.
Karsli ED, Erdogan O, Esen E, Ataturk E. Comparison of the effects of warfarin and heparin on bleeding caused by dental extraction: a clinical study. Oral Maxillofac Surg 2011 Oct;69(10):2500-2507.
Mauprivez C, Khonsari RH, Razouk O, Goudot P, Lesclous P, Descroix V. Management of dental extraction in patients undergoing anticoagulant oral direct treatment: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016 Nov;122(5):e146-e155.
Morimoto Y, Niwa H, Minematsu K. Hemostatic management for periodontal treatments in patients on oral antithrombotic therapy: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Dec;108(6):889-896.
Zanon E, Martinelli F, Bacci C, Cordioli G, Girolami A. Safety of dental extraction among consecutive patients on oral anticoagulant treatment managed using a specific dental management protocol. Blood Coagul Fibrinolysis 2003 Jan;14(1):27-30.
Muñoz-Corcuera M, Ramírez-Martínez-Acitores L, López-Pintor RM, Casañas-Gil E, Hernández-Vallejo G. Dabigatran: a new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature. Med Oral Patol Oral Cir Bucal 2016 Nov;21(6):e679-e688.
Nematullah A, Alabousi A, Blanas N, Douketic JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. Can Dent Assoc 2009 Feb;75(1):41.
van Diermen DE, van der Waal I, Hoogstraten J. Management recommendations for invasive dental treatment in patients using oral antithrombotic medication, including novel oral anticoagulants. Oral Surg Oral Med Oral Pathol Oral Radiol 2013 Dec;116(6):709-716.
Wahl MJ, Pinto A, Kilham J, Lalla RV. Dental surgery in anticoagulated patients — stop the interruption. Oral Surg Oral Med Oral Pathol Oral Radiol 2015 Feb;119(2):136-157.
Yang S, Shi Q, Liu J, Li J, Xu J. Should oral anticoagulant therapy be continued during dental extraction? A meta-analysis. BMC Oral Health 2016 Aug;16(1):81.
Doonquah L, Mitchell AD. Oral surgery for patients on anticoagulant therapy: current thoughts on patient management. Dent Clin North Am 2012 Jan;56(1):25-41.
Douketis JD, Spyropoulos AC, Spencer FA, Mayr M, Jaffer AK, Eckman MH, Dunn AS, Kunz R. Perioperative management of antithrombotic therapy: Antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 2012 Feb;141(Suppl 2):e326S-e350S.
Hirsh J, Fuster V, Ansell J, Halperin JL; American Heart Association, American College of Cardiology Foundation. American heart association/American college of cardiology foundation guide to warfarin therapy. Circulation 2003 Apr;107(12):1692-1711.
Taiwo JO, Kolude B, Akinmoladun V. Oral mucosal lesions and temporomandibular joint impairment of elderly people in the south east local government area of Ibadan. Gerodontology 2009 Sep;26(3):219-224.
Ojha R, Bhattacharyya S, Singh SK. Autophagy in cancer stem cells: a potential link between chemoresistance, recurrence, and metastasis. Biores Open Access 2015 Jan;4(1):97-108.
Newton JR, MacKenzie WE, Emens MJ, Jordan JA. Division of uterine adhesions (Asherman's syndrome) with the Nd-YAG laser. Br J Obstet Gynaecol 1989;96:102-04.
Chapman R, Chapman K. The value of two stage laser treatment for severe Asherman's syndrome. Br J Obstet Gynaecol 1996;103:1256-58.
Ahmad G, O'Flynn H, Attarbashi S, Duffy JMN, Watson A. Pain relief for outpatient hysteroscopy. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD007710. DOI: 10.1002/14651858.CD007710.pub2.
Broome JD, Vancaillie TG. Fluoroscopically guided hysteroscopic division of adhesions in severe Asherman's syndrome. Obstet Gynecol 1999;93:1041-43.
Karande V, Levrant S, Hoxsey R, Rinehart J, Gleicher N. Lysis of intrauterine adhesions using gynecoradiologic techniques. Fertil Steril 1997;68:658-62.
Chen FP, Soong YK, Hui YL. Successful treatment of severe uterine synechiae with transcervical resectoscopy combined with laminaria tent. Hum Reprod 1997;12:943-47.
Protopapas A, Shushan A, Magos A. Myometrial scoring: A new technique for the management of severe Asherman's syndrome. Fertil Steril 1998;69:860-64.
Coccia ME, Becattini C, Bracco GL, Pampaloni F, Bargelli G, Scarselli G. Pressure lavage under ultrasound guidance: A new approach for outpatient treatment of intrauterine adhesions. Fertil Steril 2001;75:601-06.
Coccia ME, Becattini C, Bracco GL, Bargelli G, Scarselli G. Intraoperative ultrasound guidance for operative hysteroscopy: A prospective study. J Reprod Med 2000;45:413-18.
Polishuk WZ, Weinstein D. The Soichet intrauterine device in the treatment of intrauterine adhesions. Acta Eur Fertil 1976;7:215-18.
March CM. Intrauterine adhesions. Obstet Gynecol Clin North Am 1995;22:491-505.
Amer MI, El Nadim A, Hassanein K. The role of intrauterine balloon after operative hysteroscopy in the prevention of intrauterine adhesion: A prospective controlled study. MEFS J 2005;10:125-29.
Amer MI, Abd-El-Maeboud KH. Amnion graft following hysteroscopic lysis of intrauterine adhesions. J Obstet Gynaecol Res 2006;32:559-66.
Burns JW, Skinner K, Colt J, Sheidlin A, Bronson R, Yaacobi Y, Goldberg EP. Prevention of tissue injury and postsurgical adhesions by precoating tissues with hyaluronic acid solutions. J Surg Res 1995;59:644-52.
De Iaco PA, Stefanetti M, Pressato D, Piana S, Dona M, Pavesio A, Bovicelli L. A novel hyaluronan-based gel in laparoscopic adhesion prevention: Preclinical evaluation in an animal model. Fertil Steril 1998;69:318-23.
Tsapanos VS, Stathopoulou LP, Papathanassopoulou VS, Tzingounis VA. The role of Seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae. J Biomed Mater Res 2002;63:10-14.
Pace S, Stentella P, Catania R, Palazzetti PL, Frega A. Endoscopic treatment of intrauterine adhesions. Clin Exp Obstet Gynecol 2003;30:26-28.
Katz Z, Ben-Arie A, Lurie S, Manor M, Insler V. Reproductive outcome following hysteroscopic adhesiolysis in Asherman's syndrome. Int J Fertil Menopausal Stud 1996;41:462-65.
Everett C. Incidence and outcome of bleeding before the 20th week of pregnancy: Prospective study fromgeneral practice. BMJ 1997;315:32-34.
Kumari AS, Haq A, Jayasundaram R, Abdel-Wareth LO, Al Haija SA, Alvarez M. Metformin monotherapy in lean women with polycystic ovary syndrome. R & Pro D. Biomed Online 2005;10:100-04.
Crave JC, Fimbel S, Lejeune H, Cugnardey N, Dechaud H, Pugeat M. Effects of diet and metformin administration on sex hormone binding globulin, androgens, and insulin in hirsute and obese women. J Clin Endocrinol Metab 1995;80:2057-62.
Pasquali R, Gambineri A, Biscotti D, Vicennati V, Gagliardi L, Colitta D, Fiorini S, Cognigni GE, Filicori M, Morselli-Labate AM. Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome. J Clin Endocrinol Metab 2000;85:2767-74.
Ehrmann DA, Cavaghan MK, Imperial J, Sturis J, Rosenfield RL, Polonsky KS. Effects of metformin on insulin secretion, insulin action, and ovarian steroidogenesis in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1997;82:524-30.
De Leo V, la Marca A, Ditto A, Morgante G, Cianci A. Effects of metformin on gonadotropin-induced ovulation in women with polycystic ovary syndrome. Fertil Steril 1999;72:282-85.
Yarali H, Yildiz B, Demirol A, Zeyneloglu HB, Yigit N, Bukulmez O, Koray Z. Co-administration of metformin during rFSH treatment in patients with clomiphene citrate-resistant polycystic ovarian syndrome: A prospective randomized trial. Hum Reprod 2002;17:289-94.
Palomba S, Falbo A, Orio F (Jr), Manguso F, Russo T, Tolino A, Colao A, Dale B, Zullo F. A randomized controlled trial evaluating metformin pretreatment and coadministration in nonobese insulin-resistant women with polycystic ovary syndrome treated with controlled ovarian hyperstimulation plus timed intercourse or intrauterine insemination. Hum Reprod 2005 Jun 15 (Epub ahead of print).
Stadtmauer LA, Toma SK, Riehl RM, Talbert LM. Metformin treatment of patients with polycystic ovary syndrome undergoing in vitro fertilization improves outcomes and is associated with modulation of the insulin-like growth factors. Fertil Steril 2001;75:505-09.
Stadtmauer LA, Toma SK, Riehl RM, Talbert LM. Impact of metformin therapy on ovarian stimulation and outcome in ‘coasted’ patients with polycystic ovary syndrome undergoing in vitro fertilization. Reprod Biomed Online 2002;5:112-16.
Glueck CJ, Phillips H, Cameron D, Sieve-Smith L, Wang P. Continuing metformin throughout pregnancy in women with polycystic ovary syndrome appears to safely reduce firsttrimester spontaneous abortion: A pilot study. Fertil Steril 2001;75:46-52.
Kocak M, Caliskan E, Simsir C, Haberal A. Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome. Fertil Steril 2002;77:101-06.
Cole PA, Robinson CH. Mechanism and inhibition of cytochrome P-450 aromatase. J Med Chem 1990;33:2933-42.
Akhtar M, Njar VC, Wright JN. Mechanistic studies on aromatase and related C-C bond cleaving P-450 enzymes. J Steroid Biochem Mol Biol 1993;44:375-87.
Palter SF, Tavares AB, Hourvitz A, Veldhuis JD, Adashi EY. Are estrogens of import to primate/human ovarian folliculogenesis? Endocr Rev 2001;22:389-424.
Weil S, Vendola K, Zhou J, Bondy CA. Androgen and follicle stimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab 1999;84:2951-56.
Vendola KA, Zhou J, Adesanya OO, Weil SJ, Bondy CA. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest 1998;101:2622-29.
Mitwally MF, Casper RF. Aromatase inhibitors for the treatment of infertility. Expert Opin Investig Drugs 2003;12:353-71.
Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am J Obstet Gynecol 2005;192:381-86.
Mitwally MFM, Casper RF. The use of aromatase inhibitor for induction of ovulation in cases of clomiphene citrate failure. Curr Opin Obstet Gynecol 2002;14:255-63.
Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 2001;75:305-09.
Sammour A, Bijan MM, Tan SL, Tulandi T. Prospective randomised trial comparing the effects of letrazole (LE) and clomiphene citrate (CC) on follicular development, endometrial thickness and pregnancy rate in patients undergoing superovulation prior to intrauterine insemination (IUI). Fertil Steril 2001;76(Suppl 1):S110.
Mitwally MF, Casper RF. Single-dose administration of an aromatase inhibitor for ovarian stimulation. Fertil Steril 2005;83:229-31.
Fisher SA, Reid RL, Van Vugt DA, Casper RF. A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women. Fertil Steril 2002;78:280-85.
Fatemi HM, Kalibianakis E, Tournaye H, Camus M, Van Steirteghem AC, Devroey P. Clomiphene citrate vs letrozole for ovarian stimulation: A pilot study. Reprod Biomed Online 2003;7:543-46.
Hu Y, Cortvrindt R, Smitz J. Effects of aromatase inhibition on in vitro follicle and oocyte development analyzed by early preantral mouse follicle culture. Mol Reprod Dev 2002;61: 549-59.
Shetty G, Krishnamurthy H, Krishnamurthy HN, Bhatnagar S, Moudgal NR. Effect of estrogen deprivation on the reproductive physiology of male and female primates. J Steroid Biochem Mol Biol 1997;61:157-66.
Mitwally MF, Casper RF. Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Hum Reprod 2003;18:1588-97.
Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril 2002;77:776-80.
Goswami SK, Das T, Chattopadhyay R, Sawhney V, Kumar J, Chaudhury K, Chakravarty BN, Kabir SN. A randomized single blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: A preliminary report. Hum Reprod 2004;19:2031-35.
Newkirk KM, Chandler HL, Parent AE, et al. Ultraviolet radiation-induced corneal degeneration in 129 mice. Toxicol Pathol 2007;35:819-26.
Pettenati MJ, Sweatt AJ, Lantz P, et al. The human cornea has a high incidence of acquired chromosome abnormalities. Hum Genet 1997;101:26-29.
Snibson GR. Collagen cross-linking: A new treatment paradigm in corneal disease—a review. Clin Experiment Ophthalmol 2010;38:141-53.
Spoerl E, Raiskup-Wolf F, Kuhlisch E, Pillunat LE. Cigarette smoking is negatively associated with keratoconus. J Refract Surg 2008;24:S737-40.
Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology 1993;100:181-86.
Goodrich DW, Lee WH. The molecular genetics of retinoblastoma. Cancer Surv 1990;9:529-54.
Moodaley LC, Woodward EG, Liu CS, Buckley RJ. Life expectancy in keratoconus. Br J Ophthalmol 1992;76:590-91.
Honein MA, Dawson AL, Petersen EE, Jones AM, Lee EH, Yazdy MM, Ahmad N, Macdonald J, Evert N, Bingham A, et al. Birth defects among fetuses and infants of US women with evidence of possible Zika virus infection during pregnancy. JAMA 2017 Jan 3;317(1):59-68.
Chervenak FA, Jeanty P, Cantraine F, Chitkara U, Venus I, Berkowitz RL, Hobbins JC. The diagnosis of fetal microcephaly. Am J Obstet Gynecol 1984 Jul 1;149(5):512-517.
Papageorghiou AT, Thilaganathan B, Bilardo CM, Ngu A, Malinger G, Herrera M, Salomon LJ, Riley LE, Copel JA. ISUOG Interim Guidance on ultrasound for Zika virus infection in pregnancy: information for healthcare professionals. Ultrasound Obstet Gynecol 2016 Apr;47(4):530-532.
Chibueze EC, Parsons AJ, Lopes KD, Yo T, Swa T, Nagata C, Horita N, Morisaki N, Balogun OO, Dagvadorj A, et al. Diagnostic accuracy of ultrasound scanning for prenatal microcephaly in the context of Zika virus infection: a systematic review and meta-analysis. Sci Rep 2017 May 23;7(1):2310.
Cordeiro MT. Zika virus: laboratory diagnosis. In: Zika in focus. Springer International Publishing; 2017. pp. 59-62.
Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodušek V, et al. Zika virus associated with microcephaly. N Engl J Med 2016 Mar 10;374(10):951-958.
Zare Mehrjardi M, Keshavarz E, Poretti A, Hazin AN. Neuroimaging findings of Zika virus infection: a review article. Jpn J Radiol 2016 Dec;34(12):765-770.
Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol 2016 Jan;47(1):6-7.
Brasil P, Pereira JP Jr, Moreira ME, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, Rabello RS, Valderramos SG, Halai UA, Salles TS, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med 2016 Dec 15;375(24):2321-2334.