A randomized clinical study: outcome of submucous resection of compensatory inferior turbinate during septoplasty* Nimet Ozalp Devseren, Mustafa Cenk Ecevit, Taner Kemal Erdag, Kerim Ceryan Dokuz Eylul University Faculty of Medicine, Department of Otorhinolaryngology, İzmir, Turkey *Received for publication: January 4, 2010; accepted: April 26, 2010 DOI:10.4193/Rhino10.006 Footnote: This study was presented at the 4 th National Rhinology Congress, 29 May–01 June 2008 in Antalya, Turkey. INTRODUCTION The most common reason for anatomic nasal stuffiness is septum deviation (SD). While anatomic SD narrows one of the nasal passages, compensatory inferior turbinate hypertrophy (TH) in the wider passage results in a decrease in the cross- sectional area of nasal patency (1) . The clinical result of this change, which is intended to ensure nasal passage turbulence, is referred to as inferior TH (2,3) . Accordingly, the presence of inferior TH is established by a subjective evaluation method (anterior rhinoscopy) (3) . Correction of a nasal deformity alone or its application together with turbinate surgery on patients with complaints of nasal obstruction is still under discussion and relies on empirical criteria (2,4) . There are studies which support the benefits of surgery on the turbinate together with a septo- plasty; however, there are studies which state this surgical procedure yields no contribution to ensure nasal patency. Fairbanks and Klainer (5) claimed that compensatory inferior TH does not spontaneously regress; rather, the nasal passage with a hypertrophied inferior turbinate gets narrower when the septum is brought to the midline. Relying on the results, they claimed that it was necessary to correct a hypertrophied inferior turbinate together with septum surgery. In the non- randomized study of Hilberg (6) , a septoplasty alone was compared with an inferior turbinoplasty and concluded that a contralateral turbinoplasty and septoplasty were successful in ensuring nasal patency in 2/3 of the patients. On the con- trary, Nunez and Bradley (3) reported that surgery involving compensatory contralateral inferior TH had no contribution in avoiding unilateral SD. The purpose of the current study was to define the effective- ness of turbinate submucous resection on nasal obstruction Background: Septoplasty and/or turbinate surgery are commonly used surgical techniques for the treatment of mechanical nasal obstruction. The aim of this study was to define the effectiveness of submucous resection of a hypertrophied turbinate together with simultaneous septoplasty for the treatment of nasal obstruction. Methods: Forty-two patients with septum deviation and compensatory contralateral inferior turbinate hypertrophy were recruited in this study. The inferior turbinate hypertrophy was diagnosed based on examination. The patients were randomly divided into two groups. In group A, a submucous resection was performed to treat a hypertrophied inferior turbinate, together with a septoplasty. In group B, only a septoplasty was performed. Acoustic rhinom- etry and rhinomanometry tests were conducted for an objective evaluation of nasal patency. A visual analog scale (VAS) was applied to the patients for the subjective evaluation of nasal obstruction complaints. Results: The application of submucous resection intended to reduce a hypertrophied inferior turbinate led to a distinctive increase in cross-sectional area of nasal patency; however, when the two groups were compared, it was statistically significant only at the post-operative sixth month. There was no difference between the results of rhinomanometry. The subjective symp- tom scores were better in group A than in group B between the post-operative first to sixth month. Conclusion: Submucous resection of a hypertrophied inferior turbinate is necessary for the treatment of nasal obstruction. Key words: septoplasty, inferior turbinate hypertrophy, submucous resection, acoustic rhi- nometry, rhinomanometry SUMMARY ORIGINAL CONTRIBUTION Rhinology, 49, 53-57, 2010 9_009693_Devseren.indd 1 01-03-2011 17:14:08