Comparative Evaluation of Middle Meatus Antrostomy with or Without Partial Middle Turbinectomy

Abstract

A considerable controversy surrounds the advisability and efficacy of middle turbinate resection in endoscopic sinus surgery. Some are in favor of middle turbinate preservation considering it to be important anatomic and physiological structure and others advocate middle turbinate resection as it improves nasal air flow and decreases synechiae formation. So a study was undertaken to evaluate the efficacy of middle turbinate resection in patients of chronic sinusitis undergoing Functional Endoscopic Sinus Surgery (FESS). 40 patients of chronic sinusitis were selected and divided into 2 groups, group I undergoing FESS with middle turbinate preservation and group II undergoing FESS along with middle turbinate resection. Final results were recorded 6 months after the operative procedure. 50% patients had relief in nasal obstruction in group I as compared to 88% in group II. Postoperative synechiae formation was seen in five patients in group I and in one patient in group II.

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…One RCT, 1 prospective nonrandomized cohort study, and 1 retrospective analysis have all shown no effect on maxillary patency. 1188,1196,1197 One retrospective study in 1992 initially found no effect, but when synechiae that might lead to maxillary stenosis were included, there was a positive effect for MT resection. 1198 It appears from these data that MT resection has no significant effect on middle meatal antrostomy patency following ESS.…”

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

“…Prospektive randomisierte Studien zeigten weniger Synechien, eine geringere Revisionsrate bzw. geringere postoperative Beschwerden und ein verbessertes Offenbleiben des Kieferhöhlenostiums, wenn die mittlere Muschel partiell reseziert wurde [233,446]. Damit scheint ausreichend abgesichert, dass eine partielle (anterior-inferiore) Resektion der mittleren Nasenmuschel unter Bewahrung der Landmarkenfunktion zumindest zulässig ist.…”

Comprehensive review on endonasal endoscopic sinus surgery

“…Prospective randomized studies reveal less synechiae, a lower rate of revisions or less postoperative complaints, and improved patency rates of the maxillary sinus ostium if the middle turbinate was partially resected [ 237 ], [ 446 ].…”