A Comparative study on the Outcome of Endoscopic Sinus Surgery With and Without Partial Middle Turbinectomy

Ansha, Eldhose (2020) A Comparative study on the Outcome of Endoscopic Sinus Surgery With and Without Partial Middle Turbinectomy. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Chronic rhino sinusitis is a common cause of morbidity affecting quality of life and ability to work effectively. Its prevalence though it varies with age, gender and geographical location was found to be 15% in general population. According to the National institute of allergy and infectious diseases, it is estimated that 134 million Indians, i.e. about 12.5% of the population, suffer from chronic rhinosinusitis. OBJECTIVES: 1. To compare and study the outcome of endoscopic sinus surgery with and without partial middle turbinate resection. 2. To confirm the significance of middle turbinate intervention as one of the most important steps for endoscopic sinus surgery. Study Design: Prospective cohort clinical study. Study Period: August 2018 to September 2019. Sample Size: 50 patients. METHOD OF STUDY: The study is conducted on 50 patients presenting with signs and symptoms of chronic rhinosinusitis satisfying the inclusion and exclusion criteria attending ENT OPD in Government Rajaji Hospital, Madurai. Approval of the institutional ethical committee obtained .Patients were randomly taken as CASE (GROUP 1) and CONTROL (GROUP 2). After taking detailed history and clinical examination, computed tomography (plain study) images of paranasal sinuses are taken. Study Group: Group 1 - Patients underwent endoscopic sinus surgery with partial middle turbinectomy. Group 2 - Patients underwent endoscopic sinus surgery without partial middle turbinectomy. The detail procedure was explained in the vernacular language and those patients willing to give written consent underwent the surgery. All cases were operated under local anaesthesia with prior prophylactic oral antibiotic medication. RESULTS: A total of 50 patients with chronic rhinosinusitis were included in this study. The ages of the patient ranged from 22 to 49 years with mean age of 35.8 years. The minimum age in the study was 22 years and the maximum age was 49 years.72% of the patients were less than 40 years of age and 28% of the patients were more than 40 years of age. Of the 50 patients, 28 were males (56%) and 22 were females (44 %). CONCLUSION: This study was conducted to compare the outcome of endoscopic sinus surgery with partial middle turbinectomy and endoscopic sinus surgery without partial middle turbinectomy in patients with chronic rhinosinusitis. And the study shows statistically significant p values in postoperative Diagnostic nasal endoscopic scores in terms of edema, discharge, synechiae and crusting and statistically significant postoperative symptomatic relief in nasal discharge and nasal obstruction in study subjects who underwent partial middle turbinectomy when compared to the study subjects who had middle turbinate preservation. As per the study, partial middle turbinectomy is reasonable as it probably prevents adhesions between the remaining middle turbinate and the freshly incised lateral nasal wall and also it improves the patency of the middle meatus. It also increases the access for future endoscopic cleaning and examination of maxillary sinus, frontal recess and ethmoid infundibulum. By preserving the posterosuperior part of middle turbinate we had preserved important landmarks for future surgery and disruption of nasal physiology and atrophic rhinitis was avoided. This study concludes that partial middle turbinectomy is a positive variable and an adjuvant technique in patients with chronic rhinosinusitis in terms of the improvement of maintenance of ventilation of osteomeatal complex and symptomatic relief.

Item Type: Thesis (Masters)
Additional Information: 221714101
Uncontrolled Keywords: Endoscopic sinus surgery, Partial middle turbinectomy, Chronic rhinosinusitis.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 15 Feb 2021 03:33
Last Modified: 15 Feb 2021 03:33
URI: http://repository-tnmgrmu.ac.in/id/eprint/14222

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