A randomised clinical trial of turbinectomy for compensatory turbinate hypertrophy in patients with anterior septal deviations

Abstract

Turbinectomy is performed at the time of nasal septal surgery by many otolaryngologists. One reason given for this procedure is the presence of a hypertrophied contralateral inferior turbinate. A randomised trial was undertaken to evaluate the relief of nasal obstruction following contralateral turbinectomy with septal surgery. Patients presenting with nasal obstruction who had a unilateral septal deviation and contralateral inferior turbinate enlargement were prospectively randomized to contralateral turbinectomy or no turbinate surgery at the time of septal surgery. Questionnaires and active anterior rhinomanometry were used for evaluation. Twenty-six patients (mean age 31 years) demonstrated a reduction in subjective and objective measures of nasal obstruction (P < 0.05) 8 weeks after operation. There was no intergroup difference, the median total decongested nasal resistance postoperatively in the non-turbinectomized patients was 0.17 kPal-1 s and 0.21 kPal-1 s in the turbinectomized patients. Contralateral inferior turbinectomy does not add to the relief of nasal obstruction beyond that attained by septal surgery in these patients.

First Findings Concerning Airflow in Noses with Septal Deviation and Compensatory Turbinate Hypertrophy – A Model Study

“…In patients one would frequently fi nd crustations at this point. In middle and posterior deviations of the nose This change in form of the lateral nasal wall is known as compensatory turbinate hypertrophy [2][3][4][5] . In models F-H, J-L and N-P, turbinates of differing sizes were introduced to compensate for the dead space caused by septal deviation.…”

“…This compensatory mechanism has been greatly documented in the medical literature [2][3][4][5] . However, a specifi c investigation of turbinate adaptation for the airfl ow dynamics in noses with septal deviation has not yet been undertaken.…”

Enlargement of Nasal Vault Diameter with Closed Septoturbinotomy

“…The turbinate procedures include subtotal or total turbinectomy, mucosal cautery, submucous resection, and turbinate fracture. [12][13][14][15][16][17][18][19] In a large series, Rohrich et al 12 advocate submucous resection as an important adjunct to rhinoplasty. Mabry 13 popularized a partial turbinectomy technique, but recommended that the surgeon perform the most conservative surgical approach to the turbinates that consistently provides a good airway in that surgeon's hands.…”

Nasal Airway Obstruction Study (NAIROS): a phase III, open-label, mixed-methods, multicentre randomised controlled trial of septoplasty versus medical management of a septal deviation with nasal obstruction

“…Objectives B and C: understanding experiences of septoplasty and non-surgical management We will investigate patients' (n = [16][17][18][19][20] and health professionals' (n = [16][17][18][19][20] experiences of the interventions and trial participation through qualitative interviews conducted during patient follow-up. Where possible, patients for the follow-up interviews will include those interviewed during the recruitment phase; additional participants will be recruited based on purposive and emergent criteria (e.g.…”

“…There is also a lack of robust evidence about the additional benefit of turbinate surgery [11]. One study showed reduced revision rates for septoplasty when the turbinate tissue is reduced [15]; other studies report no added long-term benefit from turbinate reduction [16][17][18].…”