الفهرس | Only 14 pages are availabe for public view |
Abstract Patients with obstructive symptoms who did not achieve any improvement with clinical therapy may benefit from surgical treatment. Even today, clinical experience shows that the success of the nasal functional operation depends, in many cases, on how the surgeon approaches the nasal turbinates. There are several techniques to reduce the turbinates, and according to Mabry et al., the surgeon must know all the available techniques and use them in each case, as required. Inferior turbinate surgery, which is a common nasal procedure, is indicated in patients with nasal obstruction associated with turbinate hypertrophy when nonsurgical strategies fail. It is commonly performed in association with procedures to correct other causes of nasal obstruction, deviated nasal septum, and internal valve stenosis. turbinoplasty is a procedure that aims to reduce the size of the inferior turbinate through exuberant bone removal with high mucosal preservation. The procedure is recommended for patients with or without allergic rhinitis and those showing irreversible hypertrophy of inferior turbinates. turbinoplasty is also often performed concomitantly with inferior turbinate surgery with the aim of preserving the total breathing area, which is surgically reduced, even though there is no evidence of efficacy regarding this aspect. Allergic rhinitis (AR) is one of the main causes of turbinate enlargement. It is characterized by hypersensitivity induced by immunemediated inflammation resulting from the exposure of the nasal mucosa to specific allergens. Symptoms of AR include rhinorrhea, nasal obstruction, sneezing, and postnasal drip that resolve spontaneously or following treatment. The inferior turbinate mucosa plays a central role in the pathophysiology of AR. The aim of this study was to evaluate the efficacy of inferior turbinoplasty for obstructive and non-obstructive symptoms in patients with moderate-severe persistent allergic rhinitis and refractory to medical treatment This prospective cohort observational study was carried out on 90 patients with history of moderate to severe persistent allergic rhinitis and clinically diagnosed according to the criteria of allergic rhinitis its impact on asthma (ARIA 2012) and refractory to medical treatment at the department of otorhinolaryngology Tanta university hospitals from January to December 2019. Summary of our results: • Regarding demographic data of the studied patients, age ranged from 15 – 43 years with a mean of 27.2 3± 7.52 years. There were 42 (46.67%) males and 48 (53.33%) females. • There was a significant improvement in the total nasal symptom score (TNSS) after turbinoplasty compared to before turbinoplasty (P < 0.001). • IgE level was significantly lower after turbinoplasty compared to before turbinoplasty (P =0.002). • There was a significant improvement in the Nasal Obstruction Symptom Evaluation (NOSE) scale (congestion, nasal blockade, trouble breathing, trouble sleeping and unable to get enough air) after turbinoplasty compared to before turbinoplasty (P < 0.001). • Total NOSE scale was significantly lower after turbinoplasty compared to after turbinoplasty. |