Article Type

Original Study

Subject Area

Rhinology, Endoscopic skull base surgery


Background Middle turbinate lateralization (MTL) is the most common undesirable sequela after functional endoscopic sinus surgery (FESS), which can result in recurrent sinusitis. Objectives To examine the efficacy and outcomes of different techniques to prevent failure of the primary surgery. Patients and methods Eighty patients who presented with chronic rhinosinusitis listed for FESS were enrolled in this study. Patients were divided randomly into two groups, with 40 patients each. In group A, middle turbinate (MT) was stabilized by adhesion technique, and in group B, MT was stabilized via suture technique. A comparison of the effectiveness and the outcomes of both techniques was done by assessing the MT position and synechiae formation, which is considered a primary outcome. Secondary and tertiary outcomes were assessed through Lund–Kennedy Score and Lund–Mackay, and Sino-nasal Outcome Test-8 and Sniffin Sticks identification test scores, respectively. Results Although a higher incidence of MTL and synechiae was detected in the adhesion group after 1, 3, and 6 months of follow-up, there was no significant difference between both groups, with P values of 0.74, 0.11, and 0.089, respectively. We found at the end of the sixth month postoperatively, a noticeable improvement in Lund–Kennedy Score, Lund and Mackay Score, Sino-nasal Outcome Test-8, and Sniffin Sticks identification test scores in both groups, with P values of 0.0004/0.0002, 0.001, 0.000, and 0.0002/0.0001, respectively, which are highly statistically significant differences, but there was no significant difference among both groups, with a P value of 0.24. Conclusion The primary goal must be considered to be prevention of MTL, and the medialization techniques should not be carried out routinely in FESS.


basal lamina, lateralized middle turbinate, middle turbinate, middle turbinate septal adhesion technique, synechiae, trans-septal middle turbinate suturing technique

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.