Naveen D Bhandarkar1, Timothy L Smith. 1. Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA.
Abstract
PURPOSE OF REVIEW: There are numerous available surgical techniques in use to address inferior turbinate hypertrophy. The current review will discuss the most widely used and recently studied techniques for turbinate surgery and highlight recent publications discussing clinical outcomes. RECENT FINDINGS: Microdebrider-assisted inferior turbinoplasty and radiofrequency ablation are mucosal sparing techniques that have been recently studied in direct comparison. Outcomes of the two techniques are at least equal to 6 months, although only microdebrider-assisted inferior turbinoplasty had sustained outcomes to 3 years. Recent study suggests unfavorable histological changes with radiofrequency ablation although earlier studies reported no change in nasal physiologic function. The two measures have been studied simultaneously but follow-up was only 2 months. The holmium:yttrium-aluminum-garnet (Ho:YAG) laser was found superior to the diode laser in long-term nasal patency. Few recent studies address turbinectomy. The ultrasound may be a new technique on the horizon. SUMMARY: Inferior turbinate surgery results in favorable outcomes and continues to be recommended as a treatment for turbinate hypertrophy not responsive to medical therapy. Evidence level in the literature is improving. Future well designed studies involving prospective data collection, validated outcome measures, statistical analysis, comparison or control groups, and long-term follow-up would strengthen the level of evidence.
PURPOSE OF REVIEW: There are numerous available surgical techniques in use to address inferior turbinate hypertrophy. The current review will discuss the most widely used and recently studied techniques for turbinate surgery and highlight recent publications discussing clinical outcomes. RECENT FINDINGS: Microdebrider-assisted inferior turbinoplasty and radiofrequency ablation are mucosal sparing techniques that have been recently studied in direct comparison. Outcomes of the two techniques are at least equal to 6 months, although only microdebrider-assisted inferior turbinoplasty had sustained outcomes to 3 years. Recent study suggests unfavorable histological changes with radiofrequency ablation although earlier studies reported no change in nasal physiologic function. The two measures have been studied simultaneously but follow-up was only 2 months. The holmium:yttrium-aluminum-garnet (Ho:YAG) laser was found superior to the diode laser in long-term nasal patency. Few recent studies address turbinectomy. The ultrasound may be a new technique on the horizon. SUMMARY: Inferior turbinate surgery results in favorable outcomes and continues to be recommended as a treatment for turbinate hypertrophy not responsive to medical therapy. Evidence level in the literature is improving. Future well designed studies involving prospective data collection, validated outcome measures, statistical analysis, comparison or control groups, and long-term follow-up would strengthen the level of evidence.
Authors: E De Corso; G Bastanza; V Di Donfrancesco; M L Guidi; G Morelli Sbarra; G C Passali; A Poscia; C de Waure; G Paludetti; J Galli Journal: Acta Otorhinolaryngol Ital Date: 2016-06 Impact factor: 2.124