Reduction of the inferior turbinates with a microdebrider

Year 2008, Volume: 18 Issue: 2, 69 - 73, 18.04.2008

Hasan Tanyeri Zerrin Boyacı

Abstract

Objectives: We evaluated the results of submucosal microdebrider turbinate reduction in patients with inferior turbinate hypertrophy. Patients and Methods: The study included 503 patients 190 females, 313 males; mean age 28 years; range 18-68 years who underwent turbinate reduction by a microdebrider for inferior turbinate hypertrophy. The inferior turbinates were examined by anterior rhinoscopy and nasal endoscopy before and three weeks after surgery and their size was graded from I to III. Preoperatively, 384 patients had grade II, 119 patients had grade III inferior turbinates. Of the study group, 116 patients completed a followup of two years. Results: At three weeks after surgery, none of the patients had grade III turbinates; 435 patients and 68 patients were evaluated as grade I and II, respectively. At the end of two years, none had grade III turbinates; 76 patients were grade I, 40 patients were grade II. Complaints of nasal obstruction disappeared in three weeks in 95% of patients and it did not recur in all 116 patients at the end of two years. In the early postoperative period, crusting was not observed and recovery was quick. The most common complication was mucosal tears n=114, 22.6% . Bleeding was seen in only one patient 0.2% . Conclusion: Submucosal microdebrider turbinate reduction is a safe alternative procedure and provides rapid healing with low complication rates, especially postoperative crusting.

Keywords

Debridement, hypertrophy, nasal obstruction/ surgery, turbinates/surgery

Alt konkanın mikrodebrider ile redüksiyonu

Abstract

Amaç: Hipertrofik alt konkalara submukozal mikrodebrider konka redüksiyonu uygulanan olgularda elde edilen sonuçlar değerlendirildi.Hastalar ve Yöntemler: Alt konka hipertrofisi nedeniyle mikrodebrider ile alt konka redüksiyonu uygulanan 503 hastanın sonuçları geriye dönük olarak değerlendirildi. Alt konkalar, anterior rinoskopi ve nazal endoskopi ile ameliyat öncesi ve sonrası üçüncü haftada değerlendirildi. Alt konkaların büyüklükleri derece I-III olarak sınıflandırıldı. Ameliyat öncesinde 384 hastada derece II, 119 hastada derece III konka hipertrofisi vardı. İki yıl takip edilen hasta sayısı 116 idi.Bulgular: Ameliyattan üç hafta sonraki incelemede derece III konka hipertrofisine rastlanmadı; 435 hasta derece I, 68 hasta derece II olarak değerlendirildi. İki yıllık takibi yapılan hastalarda da derece III turbinat görülmedi 76 olguda derece I, 40 olgude derece II . Hastaların %95’inde burun tıkanıklığı yakınması üç hafta içerisinde düzeldi. İki yıllık takibi yapılan 116 hastada bu yakınma tekrarlamadı. Hastalarda ameliyat sonrası erken dönemde kabuklanma görülmedi ve iyileşmenin hızlı olduğu izlendi. Mukozada yırtılma en sık izlenen komplikasyon n=114, %22.6 idi. Ameliyat sonrası kanama sadece bir hastada %0.2 görüldü. Sonuç: Submukozal mikrodebrider konka redüksiyonu çabuk iyileşme sağlayan, başta ameliyat sonrası kabuklanma olmak üzere komplikasyon oranlarını azaltan güvenilir bir seçenektir

Keywords

Debridman, hipertrofi, burun tıkanıklığı/cerrahi, turbinat/cerrahi

References

• 1. Maran AG, Lund VJ. Clinical rhinology. New York: Thieme Medical Publishers; 1990.
• 2. Martinez SA, Nissen AJ, Stock CR, Tesmer T. Nasal turbinate resection for relief of nasal obstruction. Laryngoscope 1983;93:871-5.
• 3. Ishida H, Yoshida T, Hasegawa T, Mohri M, Amatsu M. Submucous electrocautery following submucous resection of turbinate bone-a rationale of surgical treatment for allergic rhinitis. Auris Nasus Larynx 2003; 30:147-52.
• 4. Mabry RL. Inferior turbinoplasty: patient selection, technique, and long-term consequences. Otolaryngol Head Neck Surg 1988;98:60-6.
• 5. Moore JR, Bicknell PG. A comparison of cryosurgery and submucous diathermy in vasomotor rhinitis. J Laryngol Otol 1980;94:1411-3.
• 6. Coste A, Yona L, Blumen M, Louis B, Zerah F, Rugina M, et al. Radiofrequency is a safe and effective treatment of turbinate hypertrophy. Laryngoscope 2001;111: 894-9.
• 7. Supiyaphun P, Aramwatanapong P, Kerekhanjanarong V, Sastarasadhit V. KTP laser inferior turbinoplasty: an alternative procedure to treat the nasal obstruction. Auris Nasus Larynx 2003;30:59-64.
• 8. Lippert BM, Werner JA. Comparison of carbon dioxide and neodymium: yttrium-aluminum-garnet lasers in surgery of the inferior turbinate. Ann Otol Rhinol Laryngol 1997;106:1036-42.
• 9. Dawes PJ. The early complications of inferior turbinectomy. J Laryngol Otol 1987;101:1136-9.
• 10. Kimmelman CP, Ali GH. Vasomotor rhinitis. Otolaryngol Clin North Am 1986;19:65-71.
• 11. Friedman M, Tanyeri H, Lim J, Landsberg R, Caldarelli D. A safe, alternative technique for inferior turbinate reduction. Laryngoscope 1999;109:1834-7.
• 12. Sapci T, Sahin B, Karavus A, Akbulut UG. Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 2003;113:514-9.
• 13. Lippert BM, Werner JA. CO2 laser surgery of hypertrophied inferior turbinates. Rhinology 1997;35:33-6.
• 14. Wexler D, Braverman I. Partial inferior turbinectomy using the microdebrider. J Otolaryngol 2005;34:189-93.