Nasal Obstruction Septal Deviation Compensatory Inferior Turbinate Hypertrophy
Conditions
Keywords
Septorhinoplasty, Inferior turbinate hypertrophy, Nasal obstruction, Peak nasal inspiratory flowmeter, NOSE score
Brief summary
Nasal obstruction is a common complaint among patients undergoing septorhinoplasty. In addition to septal deviation, compensatory inferior turbinate hypertrophy may contribute to impaired nasal airflow. For this reason, some surgeons routinely perform inferior turbinate reduction during septorhinoplasty. However, the necessity and functional benefit of this additional procedure remain controversial. The aim of this randomized controlled study is to evaluate whether compensatory inferior turbinate surgery provides additional functional benefit when performed simultaneously with septorhinoplasty. Patients undergoing septorhinoplasty will be randomly assigned to either septorhinoplasty alone or septorhinoplasty combined with inferior turbinate surgery. Functional outcomes will be assessed using both subjective and objective measures. Subjective nasal obstruction will be evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scale, and objective nasal airflow will be assessed using peak nasal inspiratory flow (PNIF). Patients will be followed for six months after surgery. The results of this study are expected to clarify the role of compensatory inferior turbinate surgery in patients undergoing septorhinoplasty and provide evidence regarding whether routine turbinate intervention is necessary in this patient population.
Detailed description
Nasal obstruction is a common complaint among patients with nasal septal deviation and is one of the major indications for septorhinoplasty. Although correction of septal deviation often improves nasal airflow, some patients present with compensatory inferior turbinate hypertrophy that may contribute to persistent nasal obstruction. For this reason, inferior turbinate surgery is frequently performed during septorhinoplasty. However, the additional functional benefit of routine turbinate intervention in these patients remains controversial. This prospective randomized controlled study aims to evaluate the effect of compensatory inferior turbinate surgery on functional outcomes in patients undergoing septorhinoplasty. Patients with nasal obstruction due to septal deviation who are scheduled for septorhinoplasty will be enrolled and randomly assigned to one of two treatment groups: septorhinoplasty alone or septorhinoplasty combined with inferior turbinate surgery. All surgical procedures will be performed using standard septorhinoplasty techniques. In the intervention group, inferior turbinate reduction will be performed during the same surgical session. Postoperative functional outcomes will be evaluated using both subjective and objective assessment tools. Subjective nasal obstruction will be assessed with the Nasal Obstruction Symptom Evaluation (NOSE) scale, and objective nasal airflow will be measured using peak nasal inspiratory flow (PNIF). Patients will be followed for six months after surgery. Functional outcomes will be compared between the two groups to determine whether additional inferior turbinate surgery provides clinically meaningful improvement in nasal airway function when performed simultaneously with septorhinoplasty.
Interventions
PROCEDURESeptorhinoplasty
Standard open functional septorhinoplasty was performed under general anesthesia, including septoplasty, dorsal profile alignment with transverse and lateral osteotomies, tipplasty, bilateral spreader graft placement, and columellar strut grafting. Silicone nasal splints were placed bilaterally and removed after 72 hours.
PROCEDUREInferior Turbinate Surgery
Inferior turbinate reduction was performed on the non-deviated side using submucosal radiofrequency ablation followed by turbinate lateralization to improve nasal airway patency.
Sponsors
Saglik Bilimleri Universitesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
The investigator responsible for postoperative outcome assessment was blinded to the treatment allocation. Surgical procedures were performed by a single surgeon who was aware of the intervention. Participants were not blinded to the type of procedure performed.
Intervention model description
Participants are randomized in a 1:1 ratio to undergo either septorhinoplasty (SRP) alone or septorhinoplasty combined with compensatory inferior turbinate (CIT) surgery. Functional outcomes are compared between the two parallel groups using both subjective and objective measures during the postoperative follow-up period.
Eligibility
Sex/Gender
ALL
Age
18 Years to 53 Years
Healthy volunteers
No
Inclusion criteria
* Patients older than 18 years * Patients presenting with nasal obstruction and aesthetic concerns requiring septorhinoplasty * Presence of nasal septal deviation confirmed by anterior rhinoscopy, nasal endoscopy, or computed tomography * Presence of compensatory inferior turbinate hypertrophy in the contralateral nasal cavity * Patients willing to participate and able to provide informed consent
Exclusion criteria
* Previous nasal, septal, or turbinate surgery * Chronic rhinosinusitis with or without nasal polyps * Bilateral inferior turbinate hypertrophy * Absence of compensatory inferior turbinate hypertrophy * Patients requiring additional nasal procedures or grafting techniques beyond the standardized surgical protocol * Incomplete follow-up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Nasal Obstruction Symptom Evaluation (NOSE) score | Preoperative baseline and 6 months after surgery | The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated patient-reported questionnaire used to assess the severity of nasal obstruction. Scores range from 0 to 100, with higher scores indicating more severe nasal obstruction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Peak Nasal Inspiratory Flow (PNIF) | Preoperative baseline and 6 months after surgery | Peak Nasal Inspiratory Flow (PNIF) is an objective measure of nasal airflow. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORZülküf Küçüktağ, M.D.
Saglik Bilimleri Universitesi
Outcome results
None listed