Effect of Middle Turbinate Intervention on Outcomes of Middle Meatal Endoscopic Surgery
International Journal of Otorhinolaryngology
Volume 1, Issue 2, December 2015, Pages: 13-19
Received: Aug. 28, 2015; Accepted: Sep. 22, 2015; Published: Sep. 24, 2015
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Author
Khaled Mohamed Bofares, otorhinolaryngology, Omar Almoukhtar University, Elbyda, Libya
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Abstract
Back ground and objectives: Middle turbinate position, bulk, and shape play a significant role in the determination of drainage and ventilation at the middle meatus. The middle turbinate constitutes the corner stone for the performance of drainage as well as ventilation functions at the area of ostiomeatal complex and as one of major aims of middle meatal endoscopic surgery is providing the sufficient drainage and ventilation at the level of this complex thus the middle turbinate should be assessed properly before the surgery regarding its position, size, and shape which may predispose for sinusitis via the obliteration of ostiomeatal complex. In addition among the normal middle turbinate which may lateralize post-operatively and subsequently result in the re-obstruction of the drainage and ventilation at the middle meatal area therefore for the purpose of maintenance of sufficient drainage and ventilation after middle meatal endoscopic surgery it is suggested to interfere with the normal middle turbinate. For this reason the serial analytic coherent clinical study was planned prospectively to postulate for which technique is the best among previously mentioned three techniques and compared furtherly with non-interfered middle turbinate cases. Patients and methods: Sixty patients aged 14-63 years of chronic sinusitis, presented with clinical as well as radiological evidences of maxillo-ethmoidal sinusitis with or without frontal and sphenoidal involvement at ENT OPD –Al-tarahom private center Elbyda city- Libya at period in between July 2013 to March 2015 who operated by FESS, and the patients divided into four groups; group-A (n=16 ), group-B (n=18), group-C (n=6), and group-D (n=20), which include those patients who proceeded after middle meatal endoscopic surgery by the different techniques. The four groups were compared in relation to post-operative patency persistence of ipsilateral middle meatus and correlated to the incidence of sinusitis recurrence after the surgery. Results and Conclusion: 49% of the patients who underwent just medialization of ipsilateral middle turbinate without any further fixations developed recurrence of sinusitis due to re-obliteration of middle meatus either by synaechia between middle turbinate and lateral wall or by extreme lateralization of the middle turbinate as compared to the other groups among which all patients got complete improvement without any evidences of recurrence of sinusitis after one year of follow up apart of 12% of patients at group-B who presented with evidences of sinusitis recurrence after 3-6 months postoperatively. Broadly speaking, the intervention with the normal middle turbinate can be considered as one of important steps during the middle meatal endoscopic surgery that may help significantly toward the improvement of outcomes of this commonly performed procedure.
Keywords
Middle Turbinate Intervention, Middle Turbinate Medialization, Middle Turbinate Partial Turbinectomy, Middle Turbinate Stitching, Middle Turbinate Fixation
To cite this article
Khaled Mohamed Bofares, Effect of Middle Turbinate Intervention on Outcomes of Middle Meatal Endoscopic Surgery, International Journal of Otorhinolaryngology. Vol. 1, No. 2, 2015, pp. 13-19. doi: 10.11648/j.ijo.20150102.11
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