Restoration of nasal cytology after endoscopic turbinoplasty versus laser-assisted turbinoplasty.
BACKGROUND
Insult from surgical trauma leads to a degeneration of the nasal epithelium, resulting in morphological-volumetric changes involving the entire cell or a specific cell component. Alterations in normal nasal mucosa were assessed by nasal cytology and other functional tests after either endoscopic turbinoplasty or laser-assisted turbinoplasty for reducing inferior turbinate enlargement.


METHODS
A total of 150 patients with chronic nasal obstruction due to inferior turbinate hypertrophy were randomly assigned to undergo laser-assisted turbinoplasty or endoscopic turbinoplasty. Preoperative and postoperative assessment at 1 and 3 months follow-up included active anterior rhinomanometry, measurement of mucociliary transport time (MCTt), and nasal cytology to determine whether improved nasal breathing was accompanied by a restoration of preoperative nasal cytology and MCTt. One year after the operation, nasal cytology was repeated to definitively evaluate the presence of surgery-related cytological damage.


RESULTS
At both postoperative visits, nasal resistance had decreased similarly in both treatment groups; mean MCTt was significantly shorter in the endoscopic turbinoplasty-treated group (p < 0.05); at both visits, the number of altered ciliated cells had increased in the laser-assisted turbinoplasty-treated group but decreased in the endoscopic turbinoplasty-treated group, which, unlike the laser-assisted turbinoplasty-treated group, was also noted to have progressed toward a significant improvement in the goblet-to-ciliated cell ratio (p < 0.01).


CONCLUSIONS
When compared with laser-assisted turbinoplasty, endoscopic turbinoplasty is a conservative technique for inferior turbinate reduction that allows better restoration of preoperative nasal cytology and shorter MCTt.
Cassano
Michele
M
Department of Otorhinolaryngology, University of Foggia, Foggia, Italy. m.cassano@unifg.it
Granieri
Carla
C
Del Giudice
Alessandro Maselli
AM
Mora
Francesco
F
Fiocca-Matthews
Emily
E
Cassano
Pasquale
P
D000328:Adult; D000368:Aged; D001944:Breath Tests; D016923:Cell Death; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance; D009297:Nasal Mucosa / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D025363:Rhinomanometry; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control; D014420:Turbinates / Q000473:pathology / Q000601:surgery*