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Effect of turbinate surgery in rhinoseptoplasty on quality-of-life and acoustic rhinometry outcomes: A randomized clinical trial

Authors

  • Michelle Lavinsky-Wolff MD, MSc, PhD,

    Corresponding author
    1. Graduate Program in Epidemiology,of Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
    2. Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; the Otolaryngology and Head and Neck Surgery Department of Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
    • Rua Quintino Bocaiúva, 673 40 andar. Porto Alegre, Brazil, 90440-003

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  • Humberto Lopes Camargo Jr. MD, MSc,

    1. The Otolaryngology and Head and Neck Surgery Department of Complexo Hospitalar Santa Casa de Porto Alegre; Porto Alegre, Brazil
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  • Carolina Rocha Barone MS,

    1. Medical students from Universidade Federal do Rio Grande do Sul and Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre, Brazil
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  • Luisi Rabaioli MS,

    1. Medical students from Universidade Federal do Rio Grande do Sul and Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre, Brazil
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  • Fernando Herz Wolff MD; PhD,

    1. Graduate Program in Epidemiology,of Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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  • José Eduardo Lutaif Dolci MD, PhD,

    1. The Otolaryngology Department of Faculdade de Medicina da Santa Casa de São Paulo; São Paulo, Brazil
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  • Carisi Anne Polanczyk MD, ScD


  • This work was supported by Fundo de Incentivo à Pesquisa e Eventos–FIPE/HCPA. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the role of inferior turbinate reduction during rhinoseptoplasty in quality-of-life outcomes and nasal airway cross-sectional area.

Study Design:

Randomized clinical trial.

Methods:

Individuals over 16 years with nasal obstruction, candidates to functional and aesthetics primary rhinoseptoplasty, were evaluated from December 2010 though January 2012 at a tertiary University Hospital, Brazil. Eligible participants were randomly allocated to rhinoseptoplasty with or inferior turbinate reduction through submucosal diathermy. Outcomes: Relative changes ([postop–preop]/preop score) in specific (Nasal Obstruction Symptom Evaluation; NOSE) and general quality-of-life instruments (WHOQOL-bref), nasal obstruction visual analogue scale (NO-VAS) and nasal area measurements in acoustic rhinometry. Outcomes were blindly assessed 3 months postoperatively. Protocol was registered at ClinicalTrials.gov (NCT01457638).

Results:

50 patients were included, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32 ± 12 yr and 58% were female. Rhinoseptoplasty improved specific and general quality-of-life scores irrespective of turbinate intervention (P < 0.001).There was no difference between subjects submitted or not to inferior turbinate reduction in NOSE score (−75% vs. −73%; P = 0.893); all WHOQOL-bref score domains (P > 0.05), NO-VAS (−88% vs. −81%; P = 0.89) and acoustic rhinometry recordings (P > 0.05).During follow-up less patients in the rhinoplasty with inferior turbinate reduction group were using topical corticosteroids (6[24%] vs. 13[54%]; P = 0.03). Multivariable analyses, adjusting for postoperative topical corticosteroid use and previous nasal fracture, had no effect on these results.

Conclusions:

Turbinate reduction through submucosal diathermy during primary rhinoseptoplasty did not improve short-term general and specific quality-of-life outcomes and acoustic rhinometry recordings. The role of turbinate reduction in sparing chronic corticosteroid use should be confirmed in long-term follow-up studies. Laryngoscope, 2013

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