Comparison of chemical cautery (AgNo3) and steroid spray against SMD (submucosal diathermy) in the treatment of symptomatic inferior turbinate hypertrophy (ITH).
OBJECTIVE
To compare the efficacy of chemical cautery (AgNo3) and steroid nasal spray against SMD (submucosal diathermy) in the treatment of symptomatic Inferior Turbinate Hypertrophy (ITH).


METHODS
Patients attending OPD in the department of ENT &HNS at KMCTH with symptomatic Inferior turbinate Hypertrophy were taken with their approval included for the study. Patients were divided into 2 Groups: in the first Group 25 patients were included and treated with chemical cautery (AgNo3) under Local Anaesthesia (LA), followed by steroid nasal spray for 3 months; in the second Group 25 patients were included and were treated with SMD (submucosal diathermy) under General Anaesthesia (GA).They all had history of use of topical nasal decongestant for different time period. Patients were followed up for 6 months.


RESULTS
In Group 1, 16 patients complain of burning sensation for first week and 8 patients complain of continuous nasal blockage for 6 weeks.1 patient complain about inosmia for 2 weeks. In Group 2, nasal pain was complained by 17 patient for 2 weeks. 3 patients complain of persistent nasal blockage for 4 weeks. 3 patients complain of anosmia for 4 weeks. After completion of 6 months in Group 1, 20 patient has recurrent nasal blockage, whereas in Group 2, 10 patient has recurrent nasal blockage. Besides these, other symptoms noticed during initial phase did not appear.


CONCLUSIONS
Chemical cautery (AgNo3) and steroid nasal spray is easy to follow, has less complication ,but failure rate is high, whereas SMD is procedure with less failure rate, but has to carried out under GA and has more discomfort postoperatively. For symptomatic inferior turbinate hypertrophy, where topical nasal decongestant has little role SMD is the choice of treatment for longer relief.
Kafle
P
P
Department of ENT and HNS, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Maharjan
M
M
Shrestha
S
S
Toran
K C
KC
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use*; D000768:Anesthesia, General; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002425:Cautery / Q000379:methods*; D003972:Diathermy / Q000379:methods*; D005260:Female; D000068298:Fluticasone; D006801:Humans; D006984:Hypertrophy / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000628:therapy*; D012835:Silver Nitrate / Q000627:therapeutic use*; D016896:Treatment Outcome; D014420:Turbinates
D000730:Androstadienes; D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D000893:Anti-Inflammatory Agents; D012835:Silver Nitrate; D000068298:Fluticasone