Vol. 5, Issue 1, Part A (2023)

Background: Inferior turbinate hypertrophy (ITH) is considered as a common etiology of nasal obstruction. Many techniques had been discussed for reduction of the inferior turbinate size including cryoturbinectomy, submucosal resection (SMR), total and partial turbinectomy, submucosal diathermy (SMD), microdebrider assisted turbinectomy and laser turbinectomy, coblation and Radiofrequency, which have also been used to reduce the size of the turbinate. This research aimed to evaluate the effectiveness of SMR versus mixed SMD with out-fracture method for the therapy of ITH leading to nasal blockage. Forty patients over the age of 17 with chronic nasal obstruction caused by bilateral ITH owing to allergy and non-allergic rhinitis participated in a single-blinded, randomized prospective clinical study. Each participant in the research was randomly assigned to either group A (n = 20) which underwent bilateral SMR or group B (n = 20) which experienced bilateral SMD and out-fracture. Patients underwent nasal obstruction assessment using nasal obstruction symptom evaluation (NOSE) scale, visual analogue scale, stiff nasal endoscopy, computed tomography scanning of the nose and paranasal sinuses, and post-operative assessment (pain, crustation, healing).
Results: Nasal block showed marked improvement in both groups with no statistically significant difference in the 2 groups in 1 week and 1 month after operation. And with a statistically significant difference in favor of SMR group at 3 months after operation. Both groups showed marked improvement in trouble breathing, trouble sleeping and getting air during exercise with no statistically significant difference. Both groups showed a marked improvement 1 week, 1 month and 3 months after operation with a statistically significant difference in the 2 groups at 3 months after operation total NOSE score values in favor of SMR group.
Conclusions: Long-term follow-up demonstrates that submucosal excision is superior to diathermy. When reducing hypertrophy of the inferior turbinates, a SMR method is advised, particularly when a mixed turbinate component is present (bony and mucosal).