•  
  •  
 

Article Type

Article

Abstract

Back ground and objectives: Inferior turbinate surgery is considered as one of common surgical procedures which performed in rhinology. It is usually done for the purpose of reduction of the bulk of inferior turbinates. It can be conducted for different indication as to relieve the mechanical nasal obstruction due to hypertrophied inferior turbinates, or to achieve a sufficient nasal surgical access during endoscopic sinus surgery, or to remove the inferior turbinates as a part of wide and complete resection of rhino-sinus neoplastic lesions.

The inferior turbinates have important role in the maintenance of nasal breathing function via providing the nasal valve mechanism that is necessary for regulation of air flow through the nose. Therefore in spite of availability of well-established variable techniques for this surgery but the main goal of this surgery still yet not completely achieved by preserving the balance in between the mechanical as well as the functional patency of the nose. This can be explained by the effect of different factors which usually difficult to be predicted and controlled.

Thus this pattern of surgery became one of big dilemmas in rhinology which need to be deeply evaluated and subsequently resolved. For this reason, this serial study was conducted prospectively as analytic trial to assess the different aspects of this dilemma and to give finally further suggested recommendation as possible solutions for the clarification of this issue.

Patients and methods: 1337 patients aged 3-65 years of hypertrophied inferior turbinates, presented with clinical pictures of mechanical nasal obstruction related presentations at ENT department – Althowra central hospital and Al-tarahom private center Elbyda city- Libya at period in between September 2005 to September 2014 who operated by variable techniques of inferior turbinate surgery, namely sub-mucosal diathermy (SMD) (n=864 ), partial inferior turbinectomy (PIT) (n=427), CO2 laser vaporization of inferior turbinate (n=21), and turbinoplasty (n=25) . The outcomes namely post-operative atrophic rhinitis, and persistence or recurrence of the mechanical nasal obstruction was studied in relation to different factors to postulate as much as possible the clear answers for many complex questions which form this dilemma.

Results and Conclusion: The proper selection of patient for this pattern of surgery is considered as one of main aspects of this issue and one of significant steps toward the resolving of this dilemma it is very necessary to select the most suitable candidate for this surgery. On the other hand, the type of the technique for this surgery is needed to be selected probably; it was found that there are many factors, according to which the most proper technique will be selected. In addition the amount of the inferior turbinate which needed to be resected must be decided probably too. In accordance, it is necessary to confirm whether the accompanied septoplasty required to be performed in association with the inferior turbinate surgery, it was found that the septoplasty for even mild DNS (grade-I) may significantly reduce the risk of postoperative atrophic rhinitis as well as persistent functional nasal obstruction by minimizing as much as possible the resection action for inferior turbinate.

Keywords: Inferior turbinate surgery, inferior turbinectomy, sub-mucosal diathermy, turbinoplasty.

Download

Share

COinS