Effects of surgical treatment of hypertrophic turbinates on the nasal obstruction and the quality of life

Am J Otolaryngol. 2017 Nov-Dec;38(6):668-672. doi: 10.1016/j.amjoto.2017.08.009. Epub 2017 Aug 30.

Abstract

Purpose: Chronic hyperplasia of the inferior nasal concha is accompanied by a nasal obstruction; however, there is no standardised surgical treatment for this condition. Here, we compared the outcome of three surgical techniques frequently used to treat the hyperplasia of inferior turbinates: turbinectomy with lateralization, submucosal electrocautery and laser cautery additional to septoplasty.

Materials and methods: One hundred and nine patients participated in this prospective randomized study upon signing written consent. The subjects were randomly assigned to one of three intervention groups: 1) submucosal turbinectomy with lateralization, 2) submucosal electrocautery or 3) laser cautery. All groups were followed-up for up to 6months after surgical intervention. During the four follow-up appointments, the outcomes were measured with the modified German version of Sino-Nasal Outcome Test 20 questionnaire. In addition, the nasal breathing and the absolute nasal flow rates and respective mucosal component were determined by the anterior rhinomanometry.

Results: Following surgery, the subjective and objective nasal obstruction decreased significantly in all three groups. Moreover, the subjective symptoms measured by modified Sino-Nasal Outcome Test 20 improved significantly, although there were some temporal differences between groups regarding subjective nasal obstruction, ear pressure, nasal discomfort, daytime fatigue, cough and dry mouth. The mucosal component of nasal congestion decreased significantly after surgery.

Conclusions: All surgical techniques used to reduce the conchae mucosa led to a significant improvement in the objective and subjective nasal breathing and the quality of life. Septoplastic reduction proved to be of additional benefit.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Electrocoagulation
  • Female
  • Humans
  • Hypertrophy
  • Laser Therapy
  • Male
  • Middle Aged
  • Nasal Obstruction / etiology
  • Nasal Obstruction / pathology
  • Nasal Obstruction / surgery*
  • Nasal Septum / surgery
  • Nasal Surgical Procedures*
  • Prospective Studies
  • Quality of Life*
  • Rhinomanometry
  • Treatment Outcome
  • Turbinates / pathology*
  • Turbinates / surgery*
  • Young Adult