Comparative study between diathermy and microdebrider for inferior turbinate reduction surgeries

Abstract

Background: Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication. Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion: To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.

Keywords

• nasal obstruction
• inferior turbinate
• microdebrider
• diathermy