Short term subjective outcomes of lateral fracture as a complementary treatment of coblation turbinoplasty in traumatized nose

• Main Authors: Pier Giorgio Giacomini (Author), Francesco Maria Passali (Author), Barbara Flora (Author), Valentina Rosati (Author), Stefano Di Girolamo (Author)
• Format: Book
• Published: Archives of Otolaryngology and Rhinology - Peertechz Publications, 2019-03-01.
• Subjects: Clinical Techniques
• Online Access: Connect to this object online.

<p>Inferior turbinate compensatory hypertrophy is a common condition found in post-traumatic septal deviation. In literature several approaches are described for treating turbinates enlargment. We conduct a retrospective study on two group of 43 and 48 patients mached for age and sex that underwent to rino-septo-turbinoplasty from January 2011 to January 2013. First group was treated by inferior turbinates submucous unipolar coblation and the second by submucous unipolar coblation plus lateral outfracture. Inclusion criteria were: isolated nasal occlusion non-sensitive to medical treatment with compensatory enlarged inferior turbinate/s and marked nasal pyramid-septal deviation evaluated by pre-operative nasal endoscopy; turbinates hypertrophic grade from I -III according to Friedman. </p><p>"Functional" results were graded by subjective pre- and post-operative evaluation (3 and 6 months after surgery) using SF-12 and NOSE scoring systems. Turbinate volume reduced significantly (CHI square test, p<0.001) post-operatively. Grade III score from more than 1/3 of patients pre-op falls to none post-op (p<0.001). Grade II reduces from 58% to 23%. Grade I sharply increase from none pre-op to 72% post-op. These data remain grossly unchanged at 6 months endoscopy. 69/91 (83%) patients were satisfied by surgical results on nasal breathing checked by SF-12 (p < 0.01) at 3 and 6 months post-operatively.</p><p>The NOSE pre-operative scoring reduced significantly post-op. (65.6 vs 22.8, p< 0.001), early and late post-op results are similar but an increase of scores is recorded overtime. </p><p>No significant (over one minute) lengthening of surgical time was ever recorded due to the lateral outfracture of the conchal bone. A wider nasal passage by nasal endoscopy after coblation plus outfracture vs simple coblation was observed but the NOSE scores improved similarly in both groups.</p><p>The lateral outfracture of the turbinate may improve the volume of air passage through the nose without increasing of complication rates or healing time.</p>