Dilemma of Inferior Turbinate Surgery

Abstract

Background and objectives: Inferiorturbinate surgery is considered as one of most commonly performed surgery in rhinology. It is usually done to reduce the bulk of inferior turbinates. It can be conducted for different indications such as relieving the mechanical nasal obstruction due to hypertrophied inferior turbinates, or to achieving a sufficient nasal surgical access during endoscopic sinus surgery, or removing the inferior turbinates as a part of wide and complete resection of rhinosinus neoplastic lesions. The inferior turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. In spite of availability of wellestablished variable techniques for this surgery, the main goal of this surgery is yet not completely achieved. This could bean effect of different factors that are difficult to be predicted and controlled. Hence this pattern of surgery has become dilemmas in rhinology which need to be deeply evaluated and subsequently resolved. In order to evaluate and resolve this dilemma, this serial study was conducted prospectively. Patients and methods: 1337 patients aged 3 to-65 years suffering from hypertrophied inferior turbinates, presented with clinical pictures of mechanical nasal obstruction at ENT department-of Althowra central hospital and Al-tarahom private center Elbyda city-Libya between September 2005 to September 2014 they were operated by variable techniques of inferior turbinate surgery, namely sub-mucosal diathermy (SMD) (n=864), partial inferior turbinectomy (PIT) (n=427), CO 2 laser vaporization of inferior turbinate (n=21), and turbinoplasty (n=25). Post-operative atrophic rhinitis, and persistence, or recurrence of mechanical nasal obstruction the outcomes are that were studied in relation to different factors to shed-light on existing dilemma. Results and Conclusion: Proper selection of patient for this pattern of surgery is considered one of the main aspects of this issue and one of significant steps towards resolving of this dilemma. On the other hand, type of the technique for this surgery is an important selection criterion. In addition the amount of the inferior turbinate needed to be resected must be decided.