Morphological consequences of lateral outfracture of the inferior turbinate

Hanna, Brendan; Bailie, Neil; Gallagher, Geraldine; Cole, Jonathan

doi:10.1017/s0022215112003234

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Several studies have investigated surgical outcomes using patient‐reported subjective scales or objective measures of airflow, but few studies have quantified the postsurgery IT morphology and its relationship to clinical outcomes . Hanna and colleagues reported that lateral outfracture of the IT resulted in inconsistent morphological changes affecting the IT shape, size, and position. Larrabee and Kacker reviewed level 1 evidence studies (prospective, randomized trials) and concluded that, due to the lack of randomized trials comparing multiple surgical techniques, no surgical technique can be decisively selected as the best at reducing symptoms of nasal obstruction.…”

Section: Discussionmentioning

confidence: 99%

Identifying patients who may benefit from inferior turbinate reduction using computer simulations

2015

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Objectives (1) To determine objective criteria to predict which patients may benefit most from inferior turbinate reduction surgery. (2) To test whether the site of turbinate reduction, either along the nasal floor (bottom resection) or along the septal side (medial resection), impacts the extent to which nasal resistance is reduced. Study Design Case series. Methods Three-dimensional reconstructions of the nasal anatomy of five nasal airway obstruction patients were created based on pre-surgical computed tomography scans. Inferior turbinate reduction models were created for each patient using virtual surgery. Airflow, heat transfer, and humidity transport during inspiration were simulated using computational fluid dynamics (CFD). Results Nasal resistance curves revealed little to no difference between bottom resection and medial resection models. In two patients, little change was observed in nasal resistance after virtual inferior turbinate reduction, which was attributed to the narrowest cross-sections being restricted to the anterior nose (i.e., anterior to the inferior turbinate). The three patients whose nasal resistances decreased substantially after virtual inferior turbinate reduction had a narrower airspace in the turbinate region and higher nasal resistance pre-surgery. Nasal air conditioning capacity was more affected by medial resections. Conclusion CFD simulations predicted no significant difference in the decrease in nasal resistance between virtual inferior turbinate reductions performed by bottom vs. medial resection of the turbinate. However, bottom resections better preserved the calculated humidification efficiency. The simulations predicted that the greatest reduction in nasal resistance occurs in patients with highest pre-surgical resistance in the turbinate region.

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Section: Discussionmentioning

confidence: 99%

Identifying patients who may benefit from inferior turbinate reduction using computer simulations

2015

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“…They found a significant reduction in the angle and the distance between the IT bone and the lateral wall of the nasal fossa and the area lateral to the IT bone 1 and 6 months following surgery. However, Hanna et al . recently showed that lateral outfracture of the IT produced varied and inconsistent results, depending on the shape, size, and position of the IT.…”

Section: Discussionmentioning

confidence: 99%