K J Lorenz1, H Maier. 1. Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf-Hals-Chirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany. kai.lorenz@extern.uni-ulm.de
Abstract
BACKGROUND: Various methods are available for the surgical treatment of nasal airway obstruction caused by enlarged turbinates. These methods include partial turbinectomy, submucosal electrocautery, radiofrequency surgery, and laser turbinoplasty, all of which can have adverse effects such as defects of the mucous lining of the turbinates, prolonged postoperative healing, and bleeding. The purpose of this study was to analyse the effectiveness and potential adverse effects of microdebrider-assisted inferior turbinoplasty (MAIT), which is a less commonly used treatment option. MATERIALS AND METHODS: In a prospective randomized study, 35 patients underwentmicrodebrider-assisted inferior turbinoplasty. Two control groups (35 patients each) underwent conventional partial turbinectomy or submucosal electrocautery. Endoscopic and functional studies (active anterior rhinomanometry, saccharin test) were performed before surgery and 2, 4, and 24 weeks after surgery. Pain and other postoperative problems were assessed using analogue scales. RESULTS: After 2 weeks, MAIT patients, unlike the other patients, showed almost no more mucosal lesions. After 4 weeks, mean saccharin clearance time was 11.1 min in the MAIT group, 15.9 min in the partial turbinectomy group, and 13.7 min in the electrocautery group. When the patients were asked to rate their symptoms on a scale of 0-10, the mean score in the fourth postoperative week was 6.1 in the MAIT group, 7.7 in the partial turbinectomy group, and 7.8 in the electrocautery group. Rhinomanometry showed a mean flow rate increase from 178 ml/s to 574 ml/s after MAIT (401 ml/s after partial turbinectomy, 361 ml/s after electrocautery). CONCLUSION:Microdebrider-assisted inferior turbinoplasty is a minimally invasive method for reducing inferior turbinate size and maintaining mucosal integrity. It has the advantages of a short healing time, only a mild decrease in mucociliary clearance, only minor postoperative problems, and a good functional outcome.
RCT Entities:
BACKGROUND: Various methods are available for the surgical treatment of nasal airway obstruction caused by enlarged turbinates. These methods include partial turbinectomy, submucosal electrocautery, radiofrequency surgery, and laser turbinoplasty, all of which can have adverse effects such as defects of the mucous lining of the turbinates, prolonged postoperative healing, and bleeding. The purpose of this study was to analyse the effectiveness and potential adverse effects of microdebrider-assisted inferior turbinoplasty (MAIT), which is a less commonly used treatment option. MATERIALS AND METHODS: In a prospective randomized study, 35 patients underwent microdebrider-assisted inferior turbinoplasty. Two control groups (35 patients each) underwent conventional partial turbinectomy or submucosal electrocautery. Endoscopic and functional studies (active anterior rhinomanometry, saccharin test) were performed before surgery and 2, 4, and 24 weeks after surgery. Pain and other postoperative problems were assessed using analogue scales. RESULTS: After 2 weeks, MAIT patients, unlike the other patients, showed almost no more mucosal lesions. After 4 weeks, mean saccharin clearance time was 11.1 min in the MAIT group, 15.9 min in the partial turbinectomy group, and 13.7 min in the electrocautery group. When the patients were asked to rate their symptoms on a scale of 0-10, the mean score in the fourth postoperative week was 6.1 in the MAIT group, 7.7 in the partial turbinectomy group, and 7.8 in the electrocautery group. Rhinomanometry showed a mean flow rate increase from 178 ml/s to 574 ml/s after MAIT (401 ml/s after partial turbinectomy, 361 ml/s after electrocautery). CONCLUSION: Microdebrider-assisted inferior turbinoplasty is a minimally invasive method for reducing inferior turbinate size and maintaining mucosal integrity. It has the advantages of a short healing time, only a mild decrease in mucociliary clearance, only minor postoperative problems, and a good functional outcome.