Endoscopic microdebrider-assisted inferior turbinoplasty with and without posterior nasal neurectomy

Albu, Silviu; Trombitaș, Veronica; Nagy, Alina

doi:10.1016/j.anl.2013.10.018

Cited by 12 publications

(48 citation statements)

References 15 publications

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“…Cingi et al, Chieh-Feng et al, Albu et al, all of them reported that gradual decrement in postoperative pain and no patient had pain at 1 and 3 months following the surgery and this was comparable to our study. 20,30,32 No synechiae was reported during the follow up period after surgery, this might be due to placement of surgicel and silastic sheets (no raw area), and this agreed with Cingi et al, Hesham et al 10,20 No epiphora was observed from the 1 st week to the 3 rd month following the surgery, this might correlated with Barham et al, Hesham et al 10,33 …”

Section: Post-operative Complicationssupporting

confidence: 66%

Powered endoscopic inferior turbinoplasty: clinical study

Al-Helo

Falih²,

Jumma³

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Nasal obstruction is a common complaint in ENT clinics and significantly affect the patient`s quality of life. Inferior turbinate hypertrophy is one of the common causes of nasal obstruction, surgical reduction of inferior turbinate is indicated in refractory cases not responding to conservative measures and the optimal surgical technique is controversial. The aim of the study was to evaluate the clinical outcomes of powered endoscopic inferior turbinoplasty in the management of inferior turbinate hypertrophy. Methods: An interventional study (single group clinical trial) was conducted and powered endoscopic inferior turbinoplasty was performed on 30 patients complaining of chronic nasal obstruction due to inferior turbinate hypertrophy and other causes of nasal obstruction were excluded. Results: Assessed preoperatively and 1st week, 1st month and 3rd month postoperatively depending on subjective visual analogue scale scores for nasal obstruction, endoscopic grading system and complications. There was significant improvement in nasal obstruction and significant reduction in inferior turbinate size and mild complications that completely absent at the third month following the surgery. Conclusions: Microdebrider-assisted inferior turbinoplasty as a safe, effective and reliable alternative method for inferior turbinate reduction.

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Section: Post-operative Complicationssupporting

confidence: 66%

Powered endoscopic inferior turbinoplasty: clinical study

Al-Helo

Falih²,

Jumma³

2017

Int J Otorhinolaryngol Head Neck Surg

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“…Where outcomes were reported, all the studies reported a significant improvement in rhinorrhea and most of them also observed an improvement in nasal obstruction for vasomotor rhinitis (Table ). Studies on allergic rhinitis subjects also reported improvement in rhinorrhea and nasal obstruction but had mixed results in terms of benefits for sneezing and itching . Results are detailed in Table .…”

Section: Vidian Neurectomymentioning

confidence: 98%

“…Of these 18 studies, two‐thirds were case series (12/18). Other original studies also included: 3 case‐control studies, 1 cohort trial, and 2 RCTs …”

Section: Vidian Neurectomymentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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“…11 Some previous reports have described the beneficial effects of PNN on rhinorrhea and sneezing, 6-10 although other reports have failed to observe an effect of PNN on sneezing. 11,12 The histological changes underlying the effects of PNN have not been elucidated because of the limitations of human studies and the lack of animal models.In the present study, we developed an animal model of PNN and examined the effect of PNN on the nasal mucosal structure and function. We also investigated the therapeutic effects of PNN on experimental allergic rhinitis to elucidate…”

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confidence: 99%

Denervation of nasal mucosa induced by posterior nasal neurectomy suppresses nasal secretion, not hypersensitivity, in an allergic rhinitis rat model

Nishijima

Kondo

Toma-Hirano

et al. 2016

Laboratory Investigation

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The posterior nasal nerve is the dominant source of the parasympathetic, sympathetic, and sensory fibers that innervate the nasal respiratory mucosa. Therefore, a posterior nasal neurectomy (PNN) is thought to induce denervation of the nasal mucosa and relieve the nasal symptoms of allergic rhinitis. However, the underlying mechanisms and therapeutic action of PNN remain unknown. To investigate the impact of PNN-induced denervation of the nasal mucosa on allergic rhinitis, we developed a rat model of PNN and examined the effects of PNN on allergic rhinitis in ovalbumin-sensitized rats. This rat model of PNN was characterized by the depletion of nerve fibers, choline acetyltransferase, and neuropeptides (eg, substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and neuropeptide Y) in the nasal respiratory mucosa. These animals exhibited nasal gland and goblet cell hypertrophy in the septal mucosa and atrophy of the submucosal gland in the lateral nasal wall, as well as reduced nasal secretion due to deficient acetylcholine synthesis. In an ovalbumin-sensitized model of allergic rhinitis, PNN also induced the depletion of nerve fibers, choline acetyltransferase, and neuropeptides in the nasal mucosa and suppressed nasal secretion. However, PNN did not affect mucosal thickening, eosinophil and mast cell infiltration, interleukin-4 and interferon-γ mRNA expression, and allergic symptoms (ie, sneezing and nasal scratching). These results suggest that the peripheral nerves and corresponding neuropeptides regulate nasal secretion, but not hypersensitivity, in allergic rhinitis, and that allergic rhinitis-related mucosal reactions occur in a highly denervated mucosa after PNN. Posterior nasal neurectomy may be a therapeutic option for the treatment of hyperrhinorrhea, but not allergic rhinitis hypersensitivity. Allergic rhinitis is among the most common diseases; affecting 10-30% of people in industrialized countries. [1][2][3] This condition presents with symptoms that reduce the quality of life such as rhinorrhea, sneezing, nasal obstruction, and nasal itching. 4 Medical allergic rhinitis treatment is approached in a stepwise manner and includes agents such as antihistamines and nasal topical steroids. 1,2,5 However, for patients with allergic rhinitis refractory to medication therapy; surgical interventions such as endoscopic posterior nasal neurectomy (PNN) have been attempted.Endoscopic PNN, which involves the intranasal severing of the posterior nasal nerve, is a common surgical treatment for allergic rhinitis in Asia. 2,6,7 The posterior nasal nerve, which is a peripheral branch of the vidian nerve, innervates the nasal cavity via the pterygopalatine ganglion, which comprises parasympathetic and sympathetic vidian nerve fibers and sensory nerve fibers from the trigeminal nerve. Therefore, PNN is expected to suppress nasal hypersecretion by blocking autonomic vidian nerve fibers, similar to vidian neurectomy (VN), as well as hypersensitivity by simultaneously blocking sensory nerve fibers. 6...

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Endoscopic microdebrider-assisted inferior turbinoplasty with and without posterior nasal neurectomy

Cited by 12 publications

References 15 publications

Powered endoscopic inferior turbinoplasty: clinical study

Powered endoscopic inferior turbinoplasty: clinical study

ICAR: endoscopic skull‐base surgery

Denervation of nasal mucosa induced by posterior nasal neurectomy suppresses nasal secretion, not hypersensitivity, in an allergic rhinitis rat model

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