The following is the summary of “Systematic Review of Surgical Interventions for Inferior Turbinate Hypertrophy” published in the October 2022 issue of Rhinology and allergy by Zhang, et al.
Multiple surgical procedures can be used to address enlarged turbinates in the lower airway and inferior turbinate hypertrophy (ITH). Although mucosal-sparing methods are preferable, there is no agreement on the best method. The purpose of this review was to conduct a meta-analysis of predicted outcomes following inferior turbinate reduction (ITR) for the treatment of bilateral nasal blockage. Articles reporting surgical treatment for ITH were sought out using a search of the PubMed, Scopus, and Cochrane Library databases. Non-mucosal ITH or concurrent nasal operations were also deal breakers.
The primary measures were a visual analog scale for nasal blockage, acoustic rhinometry for nasal cavity volume, and anterior rhinomanometry for resistance. In addition, Radiofrequency ablation (RFA) and microdebrider-assisted turbinoplasty (MAIT) were compared, and their efficacy was evaluated in subgroup analyses stratified by rhinitis diagnosis and duration of follow-up. From the initial search of 1,870 studies, 62 met the criteria for inclusion. Turbinectomy, submucosal excision, radiofrequency ablation, microwave ablation in situ, laser, and electrocautery were among the methods described. Using the visual analog scale, each method significantly reduced nasal blockage. Nasal resistance, nasal cavity volume, and nasal airflow were all significantly enhanced after RFA, MAIT, and laser treatment compared to pre-treatment levels.
The VAS, nasal cavity volume, and resistance outcomes from the 6 trials that directly evaluated RFA and MAIT were statistically similar over the median 3.5-month follow-up period. When looking at VAS congestion over time, researchers see the most improvement between 3 and 6 months. Nasal obstruction is alleviated with all of the reviewed ITR methods. Although the benefits of RFA and MAIT are maintained over the long term, the maximal benefit for both methods appears to be obtained within the first year, as measured by patient-reported and physiologic nasal airflow outcomes.