Inferior Turbinate Reduction Surgery by partial inferior turbinectomy versus radiofrequency turbinectomy

Abstract

Nasal valve is the narrowest portion of the whole nasal cavity. It contributes the maximum to the nasal airway resistance. Anatomically this area lies just anterior to the inferior turbinate, about 2 cm distal to the nasal aperture, with an average cross sectional area of about 0.73 cm2. It is governed by the size of the inferior turbinate, nasal septum and the upper lateral cartilage. So swelling of inferior turbinate has an important determining effect in the nasal resistance. Allergic rhinitis is the most common cause of turbinate dysfunction; it is due to environmental allergens that come in contact with the nasal membranes, causing an inflammatory reaction. Vasomotor is a term that indicates the neurovascular control of the nasal membranes. Causes of vasomotor rhinitis include, but are not limited to, the use of cardiovascular and antihypertensive drugs, female hormones, changes in temperature, and rhinitis of disuse. Medical therapy is the first-line approach to the treatment of turbinate dysfunction; however, the appropriate choice of therapy relies on the appropriate diagnosis. In many cases intranasal topical steroids, antihistamines and decongestants often yield good results. Patients who do not respond will usually be treated by surgical reduction of the turbinate. Since the last quarter of the 19th century, at least 13 different techniques have been introduced. Some of them have already been abandoned, whereas others are still in use or have been reintroduced. An ideal procedure for turbinate reduction should be associated with minimal discomfort or adverse reactions and should preserve the physiological function of the turbinate, such as regulating the humidification and temperature of the inspired air. In this study, trying to reach which is better partial inferior turbinectomy or radiofrequency ablation by comparing the following outcomes: Improvement of nasal obstruction, hyposmia and nasal discharge, postoperative crustations, bleeding and atrophic rhinitis. Both partial inferior turbinectomy and inferior turbinate reduction by radiofrequency ablation show the close results regarding improvement of nasal obstruction, postoperative crustations, hyposmia, and postoperative atrophic rhinitis. But radiofrequency ablation shows better results for improvement of rhinorrhea and lower rates of postoperative bleeding. However the main question of the study" which is better partial inferior turbinectomy or radiofrequency ablation?" couldn't be answered as there was no enough comparative studies with similar outcomes to be introduced in meta-analysis We recommend doing more comparative, prospective studies and clinical trials on comparing partial inferior turbinectomy and radiofrequency ablation with long term postoperative follow up.