No CrossRef data available.
Article contents
The role of using the submucosal conchoplasty technique for the management of concha bullosa in decreasing post-operative middle meatus synechia formation after functional endoscopic sinus surgery: a randomised controlled trial
Published online by Cambridge University Press: 29 April 2024
Abstract
Objective
The study aimed to compare the applicability of classic lateral lamellectomy versus submucosal conchoplasty techniques in managing concha bullosa during and after functional endoscopic sinus surgery.
Methods
The study randomly divided 56 patients with bilateral concha bullosa into two groups. One group of patients underwent the submucosal conchoplasty technique and the other group underwent the lateral lamellectomy technique. The study compared the intra-operative findings, including the time required for each technique, the amount of intra-operative bleeding and the post-operative endoscopic outcome of the middle meatus and middle turbinate stability.
Results
Submucosal conchoplasty was significantly more time-consuming than the lateral lamellectomy technique (p = 0.001*). The difference in the intra-operative amount of bleeding was (p = 0.086*). The lateral lamellectomy group showed a higher rate of synechia formation in the middle meatus (p = 0.012*).
Conclusion
Submucosal conchoplasty is a valid technique for managing concha bullosa with better post-operative endoscopic outcomes.
- Type
- Main Article
- Information
- Copyright
- Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED
Footnotes
Ali Gamal Ali Elouny takes responsibility for the integrity of the content of the paper
References
Dasar, U, Gokce, E. Evaluation of variations in sinonasal region with computed tomography. World J Radiol 2016;8:98–108Google Scholar
Fadda, GL, Rosso, S, Aversa, S, Petrelli, A, Ondolo, C, Succo, G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital 2012;32:244–51Google Scholar
Maru, YK, Gupta, Y. Concha bullosa: frequency and appearances on sinonasal CT. Indian J Otolaryngol Head Neck Surg 1999;52:40–4Google Scholar
Bolger, WE, Butzin, CA, Parsons, DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991;101:56–64Google Scholar
Kumral, TL, Yıldırım, G, Cakır, O, Ataç, E, Berkiten, G, Saltürk, Z et al. Comparison of two partial middle turbinectomy techniques for the treatment of a concha bullosa. Laryngoscope 2015;125:1062–6Google Scholar
Apuhan, T, Yıldırım, YS, Şimşek, T, Yılmaz, F, Yılmaz, F. Concha bullosa surgery and the distribution of human olfactory neuroepithelium. Eur Arch Otorhinolaryngol 2013;270:953–7Google Scholar
Nurse, LA, Duncavage, JA. Surgery of the inferior and middle turbinates. Otolaryngol Clin North Am 2009;42:295–309Google Scholar
Soler, ZM, Hwang, PH, Mace, J, Smith, TL. Outcomes after middle turbinate resection: revisiting a controversial topic. Laryngoscope 2010;120:832–7Google Scholar
Khalil, YA, Aboel-naga, HA, Adel Hussein, H, GadAllah, AH. Comparative study between lateral laminectomy and conchoplasty in the surgical treatment of symptomatic middle turbinate Concha Bullosa. Egyptian Journal of Ear, Nose, Throat and Allied Sciences 2018;19:80–6Google Scholar
Dogru, H, Tuz, M, Uygur, K, Çetin, M. A new turbinoplasty technique for the management of concha bullosa: our short-term outcomes. Laryngoscope 2001;111:172–4Google Scholar
Ahmed, EA, Hanci, D, Üstün, O, Aydogdu I, Özdemir E, Karaketir S et al. Surgıcal techniques for the treatment of concha bullosa: a systematic review. Otolaryngol Open J 2018;4:9–14Google Scholar
French, C, Goyal, P. Submucosal resection of the middle turbinate. Otolaryngol Head Neck Surg 2012;147:116Google Scholar
Dubin, MG, Liu, C, Lin, SY, Senior, BA. American Rhinologic Society member survey on ‘maximal medical therapy’ for chronic rhinosinusitis. Am J Rhinol 2007;21:483–8Google Scholar
Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:1–2Google Scholar
Kelsey, JL, Whittemore, AS, Evans, AS, Thompson, WD. Methods in Observational Epidemiology. New York: Oxford University Press, 1986Google Scholar
Hopkins, C, Browne, JP, Slack, R, Lund, V, Brown, P. The Lund–Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict? Otolaryngol Head Neck Surg 2007;137:555–61Google Scholar
Fromme, GA, MacKenzie, RA, Gould, AB Jr, Lund, BA, Offord, KP. Controlled hypotension for orthognathic surgery. Anesth Analg 1986;65:683–6Google Scholar
Hopkins, C, Gillett, S, Slack, R, Lund, VJ, Browne, JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009;34:447–54Google Scholar
Khafagy, Y, Ghonim, M, Elgendy, A, Elzayat, S. The impact of bolgerization versus partial resection of the middle turbinate on frontal sinusotomy patency outcome: a randomised controlled study. Clin Otolaryngol 2021;46:954–60Google Scholar
Lund, VJ, Kennedy, DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:S35–40Google Scholar
Wright, ED, Agrawal, S. Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel Perioperative Sinus Endoscopy (POSE) scoring system. Laryngoscope 2007;117:1–28Google Scholar
Sigston, EA, Iseli, CE, Iseli, TA. Concha bullosa: reducing middle meatal adhesions by preserving the lateral mucosa as a posterior pedicle flap. J Laryngol Otol 2004;118:799–803Google Scholar
Nyquist, GG, Anand, VK, Brown, S, Singh, A, Tabaee, A, Schwartz, TH. Middle turbinate preservation in endoscopic transsphenoidal surgery of the anterior skull base. Skull Base 2010;20:343–7Google Scholar
Lee, HY, Kim, HU, Kim, SS, Son, EJ, Kim, JW, Cho, NH et al. Surgical anatomy of the sphenopalatine artery in lateral nasal wall. Laryngoscope 2002;112:1813–18Google Scholar