TURBINOPLASTY USING SUBMUCOSAL MICRODEBRIDER, RADIOFREQUENCY AND CONVENTIONAL SURGICAL, WHAT IS THE BEST?
Amr F. El-Badry, Aly A. Abdelrahman, Ahmed S. Gad, Ahmed M. Abdel-Fattah, and Mustafa I. Eid
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
Background: Nasal inferior turbinate hypertrophy is one of the most common causes of nasal obstruction. Many different surgical methods are currently available. Patients and Methods: This prospective observational study was conducted for 3.5 years (between 2009 and 2012) on 60 patients with nasal obstruction and diagnosed as hypertrophied inferior turbinate. These patients were attending Otorhinolaryngology Department, Al-Azhar University Hospitals in Egypt. Aims: To determine the best objective result technique of powered submucosal inferior turbinoplasty using special microdebrider blade for turbinoplasty comparing it with radiofrequency turbinoplasty and conventional surgical turbinoplasty and follow up of the patients to detect any possible complications. The mean follow-up time was 2 years. Results: The study showed significant difference in bleeding between the three groups postoperatively (P <0.05), but there was no significant difference in nasal crustation between the three groups (P >0.05). Acoustic rhinometry showing significant improvement in width of minimal cross sectional area in all groups after 6 months, 1, and 2 years (P <0.05). The least width was in the radiofrequency group, about 0.15±0.06 cm, which represents 38.6±24% after 2 years. Mucociliary clearance time, assisted by saccharin test, significantly decreased (P <0.05) in all groups all over the study. There was no significant difference (P >0.05) between the three groups after 6 months postoperatively but after 1 and 2 years there was a significant difference between the three groups (P <0.05). Conclusion: Radiofrequency turbinoplasty is the procedure that can be done under local anesthesia. The microdebrider submucosal turbinoplasty is the procedure of highest efficacy and least complication so it must be the procedure of choice if the device is available.