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Inferior turbinate reduction: comparing post-operative bleeding between different surgical techniques

Published online by Cambridge University Press:  27 October 2021

E Levy ,
O Ronen ,
E Sela ,
E Layos ,
N Eisenbach ,
N Ibrahim ,
AA Dror ,
A Daoud  and
T Marshak
E Levy*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
O Ronen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
E Sela
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
E Layos
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
N Eisenbach
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
N Ibrahim
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
AA Dror
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
A Daoud
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
T Marshak
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
*
Author for correspondence: Dr Einat Levy, Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, POB 21, Nahariya2210001, Israel E-mail: [email protected]
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Abstract

Objective

Post-operative bleeding is one of the most common and severe complications of turbinate surgery. This study compared post-operative bleeding following partial turbinectomy, submucosal turbinate reduction and endoscopic turbinoplasty.

Methods

Post-operative bleeding was assessed in patients who underwent inferior turbinate intervention by partial turbinectomy, submucosal turbinate reduction or endoscopic turbinoplasty between January 2016 and November 2017 and had completed at least one month of follow up.

Results

Of 1035 patients who underwent inferior turbinate surgery during the study period, 751 were included. Of these, 56 (7.5 per cent) presented to the emergency room with post-operative bleeding; 31 (8.4 per cent) had undergone partial turbinectomy, 19 (10.7 per cent) had undergone submucosal turbinate reduction and 6 (3.0 per cent) had undergone endoscopic turbinoplasty. The odds ratio of requiring an intervention to control bleeding was significantly lower in the endoscopic turbinoplasty group than in the submucosal turbinate reduction group (odds ratio = 3.26, 95 per cent confidence interval = 1.02–10.43).

Conclusion

Endoscopic turbinoplasty had the lowest rate of post-operative bleeding and the lowest rate of patients requiring intervention.

Keywords

TurbinatesNasal Surgical ProceduresEpistaxisPostoperative Hemorrhage
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 5 , May 2022 , pp. 427 - 432
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Levy takes responsibility for the integrity of the content of the paper

Preliminary data from this project were presented at the 27th Congress of the European Rhinology Society, 22–26 April 2018, London, UK, and at the Annual Meeting of the Israeli Otolaryngology – Head and Neck Surgery Society, 7–10 March 2018, Eilat, Israel.

References

Mori, S, Fujieda, S, Igarashi, M, Fan, GK, Saito, H. Submucous turbinectomy decreases not only nasal stiffness but also sneezing and rhinorrhea in patients with perennial allergic rhinitis. Clin Exp Allergy 1999;29:1542–8CrossRefGoogle Scholar
Brunworth, J, Holmes, J, Sindwani, R. Inferior turbinate hypertrophy: review and graduated approach to surgical management. Am J Rhinol Allergy 2013;27:411–15CrossRefGoogle ScholarPubMed
Eliashar, R. Total inferior turbinectomy: operative results and technique. Ann Otol Rhinol Laryngol 2001;110:700Google ScholarPubMed
Elwany, S, Harrison, R. Inferior turbinectomy: comparison of four techniques. J Laryngol Otol 1990;104:206–9CrossRefGoogle ScholarPubMed
Sapçi, T, Sahin, B, Karavus, A, Akbulut, UG. Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 2003;113:514–19Google ScholarPubMed
Sinno, S, Mehta, K, Lee, ZH, Kidwai, S, Saadeh, PB, Lee, MR. Inferior turbinate hypertrophy in rhinoplasty: systematic review of surgical techniques. Plast Reconstr Surg 2016;138:419–29eCrossRefGoogle ScholarPubMed
Barham, HP, Thornton, MA, Knisely, A, Marcells, GN, Harvey, RJ, Sacks, R. Long-term outcomes in medial flap inferior turbinoplasty are superior to submucosal electrocautery and submucosal powered turbinate reduction. Int Forum Allergy Rhinol 2016;6:143–7CrossRefGoogle ScholarPubMed
Fradis, M, Danino, J, Gaitini, L, Gershinski, M, Malatskey, S, Golz, A et al. Inferior turbinectomy versus submucosal diathermy for inferior turbinate hypertrophy. Ann Otol Rhinol Laryngol 2000;109:1040–5CrossRefGoogle ScholarPubMed
Batra, PS, Seiden, AM, Smith, TL. Surgical management of adult inferior turbinate hypertrophy: a systematic review of the evidence. Laryngoscope 2009;119:1819–27CrossRefGoogle Scholar
Barham, HP, Knisely, A, Harvey, RJ, Sacks, R. How I do it: medial flap inferior turbinoplasty. Am J Rhinol Allergy 2015;29:314–15CrossRefGoogle Scholar
Gupta, A, Mercurio, E, Bielamowicz, S. Endoscopic inferior turbinate reduction: an outcomes analysis. Laryngoscope 2001;111:1957–9CrossRefGoogle ScholarPubMed
Nurse, LA, Duncavage, JA. Surgery of the inferior and middle turbinates. Otolaryngol Clin North Am 2009;42:295–309CrossRefGoogle ScholarPubMed
Bergmark, RW, Gray, ST. Surgical management of turbinate hypertrophy. Otolaryngol Clin North Am 2018;51:919–28CrossRefGoogle ScholarPubMed
Hong, HR, Jang, YJ. Correlation between remnant inferior turbinate volume and symptom severity of empty nose syndrome. Laryngoscope 2016;126:1290–5CrossRefGoogle ScholarPubMed
Spielberg, W. The treatment of nasal obstruction by submucous resection of the inferior turbinate bone: report of cases. Laryngoscope 1924;34:197–203CrossRefGoogle Scholar
House, HP. Submucous resection of the inferior turbinal bone. Laryngoscope 1951;61:637–48CrossRefGoogle ScholarPubMed
Jackson, LE, Koch, RJ. Controversies in the management of inferior turbinate hypertrophy: a comprehensive review. Plast Reconstr Surg 1999;103:300–12CrossRefGoogle ScholarPubMed
Chen, Y-L, Tan, C-T, Huang, H-M. Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope 2008;118:1270–4CrossRefGoogle ScholarPubMed
Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2LEN and AllerGen). J Allergy Clin Immunol 2008;63:8–160CrossRefGoogle Scholar
Zhang, P, He, J, Fang, Y, Chen, P, Liang, Y, Wang, J. Efficacy and safety of intravenous tranexamic acid administration in patients undergoing hip fracture surgery for hemostasis. Medicine 2017;96:e6940CrossRefGoogle ScholarPubMed
Perel, P, Ker, K, Morales Uribe, CH, Roberts, I. Tranexamic acid for reducing mortality in emergency and urgent surgery. Cochrane Database Syst Rev 2013;(1):CD010245Google ScholarPubMed
Joseph, J, Martinez-Devesa, P, Bellorini, J, Burton, MJ. Tranexamic acid for patients with nasal haemorrhage (epistaxis). Cochrane Database Syst Rev 2018;(12):CD004328Google Scholar