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Inferior Turbinate Hypertrophy in Rhinoplasty: Systematic Review of Surgical Techniques

Sinno, Sammy M.D.; Mehta, Karan M.D.; Lee, Z-Hye M.D.; Kidwai, Sarah M.D.; Saadeh, Pierre B. M.D.; Lee, Michael R. M.D.

Plastic and Reconstructive Surgery: September 2016 - Volume 138 - Issue 3 - p 419e-429e
doi: 10.1097/PRS.0000000000002433
Cosmetic: Original Articles
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Background: Inferior turbinate hypertrophy is often encountered by plastic surgeons who perform rhinoplasty. Many treatment options are available to treat the inferior turbinate. The objective of this study was to systematically review outcomes of available techniques and provide guidance to surgical turbinate management.

Methods: A MEDLINE search was performed for means of treating inferior turbinate hypertrophy. Studies selected focused on treatment of the inferior turbinate in isolation and excluding patients with refractory allergic rhinitis, vasomotor rhinitis, or hypertrophic rhinitis.

Results: Fifty-eight articles were identified, collectively including the following surgical treatments of inferior turbinate hypertrophy: total turbinectomy, partial turbinectomy, submucosal resection, laser surgery, cryotherapy, electrocautery, radiofrequency ablation, and turbinate outfracture. Outcomes and complications were collected from all studies. Procedures such as turbinectomy (partial/total) and submucosal resection showed crusting and epistaxis at comparatively higher rates, whereas more conservative treatments such as cryotherapy and submucous diathermy failed to provide long-term results. Submucosal resection and radiofrequency ablation were shown to decrease nasal resistance and preserve mucosal function. No literature exists to support the belief that turbinate outfracture alone is an effective treatment for turbinate hypertrophy.

Conclusions: Treatment of inferior turbinate hypertrophy is best accomplished with modalities that provide long-lasting results, preservation of turbinate function, and low complication rates. Submucosal resection and radiofrequency ablation appear to best fulfill these criteria. Turbinate outfracture should only be considered in combination with tissue-reduction procedures.

New York, N.Y.; and Shreveport, La.

From the Wyss Department of Plastic Surgery, New York University Medical Center; and The Wall Center for Plastic Surgery.

Received for publication December 12, 2015; accepted April 12, 2016.

Disclosure:The authors have no financial interests to disclose.

Michael R. Lee, M.D., The Wall Center for Plastic Surgery, 8600 Fern Avenue, Shreveport, La. 71105, michaellee.prs@gmail.com

Copyright © 2016 by the American Society of Plastic Surgeons