The study aimed to compare two different techniques of middle turbinate (preservation
versus resection) in endoscopic surgical treatment of extensive sinonasal polyposis and analyzing its effect on
recurrence rates and postoperative nasal airflow resistance. Study design: A prospective study was performed.
Patients & Methods: Forty patients with a mean age of 35.3 years, with sinonasal polyposis stage 3 at endoscopic
evaluation and a Kennedy score of (IV) were recruited in this study. The patients had been classified into two
groups; group (A) with middle turbinate preservation, which include 20 patients and group (B) with middle turbinate
resection, which include also 20 patients. Recurrence rates were evaluated in a 2-year follow-up. For functional
evaluation, we applied anterior active rhinomanometry one week preoperatively and 6 months postoperatively to
determine nasal airflow resistance (NAR) and to compare the difference between the two groups. Results:
Postoperative synechia was reported in 6 cases of group (A), while in group (B) no cases were detected. The
difference in the two groups was strongly statistically significant (P<0.05). Regarding to recurrence of polyposis, in
group (A), 12 patients showed recurrence, while in group (B), 6 patients showed recurrence. The difference in the
two groups was statistically significant (z test 1.9, p <0.005). The patients of both groups showed significant
reduction of mean NAR after surgery in both nostrils(p < 0.00l). Conclusion; A better control of relapse of
sinonasal polyposis in patients subjected to resection compared with patients subjected to conservative surgery on
middle turbinate. By leaving the superior and posterior parts of the turbinate, the anatomical landmarks are
preserved. No significant short or long-term complications have resulted from our partial resection of the middle
turbinate. We recommended partial middle turbinate resection in endoscopic surgical management of extensive
sinonasal polyposis. |
