Publication:

Comparative evaluation of surgical techniques for inferior turbinate hypertrophy: a prospective observational study

Background Inferior turbinate hypertrophy (ITH) is a common cause of chronic nasal obstruction and significantly affects quality of life. When medical management fails, surgical reduction of the inferior turbinate is indicated. Multiple surgical techniques are available, but comparative evidence regarding their outcomes remains variable. To evaluate and compare the effectiveness of different surgical techniques for the management of inferior turbinate hypertrophy using subjective symptom assessment and objective endoscopic findings.

Methods This prospective comparative observational study was conducted over 18 months at a tertiary care hospital and included 100 patients aged 18–65 years with chronic nasal obstruction due to inferior turbinate hypertrophy refractory to medical therapy. Patients underwent partial inferior turbinectomy (n=32), powered turbinectomy (n=21), submucous diathermy (n=25) or submucous resection (n=22). Nasal obstruction was assessed subjectively using the Visual Analogue Scale (VAS) and turbinate size was graded endoscopically preoperatively and at 3 months postoperatively. Statistical analysis was performed using SPSS, with p < 0.05 considered significant.

Results The mean age was 40.92±14.05 years, with 59% males. Preoperatively, 64% of patients had severe nasal obstruction and 82% had Grade III turbinate hypertrophy. Mean VAS scores improved significantly from 8.06±1.41 to 3.57±1.79 postoperatively, with a mean improvement of 4.49±1.10. Postoperatively, 52% reported mild symptoms. Significant associations were observed between pre- and postoperative VAS severity (p=0.013) and turbinate grade (p=0.003). Although powered turbinectomy showed the highest mean VAS improvement, differences among techniques were not statistically significant (p=0.165). Overall complication rate was 17%, with epistaxis being most common. Patient satisfaction correlated significantly with VAS improvement (p<0.001).

Conclusions All four surgical techniques resulted in significant symptomatic and objective improvement with acceptable complication rates. No single technique demonstrated clear superiority, highlighting the importance of individualized surgical selection.