Effect of turbinate surgery in rhinoseptoplasty on quality-of-life and acoustic rhinometry outcomes: a randomized clinical trial.
OBJECTIVE
To evaluate the role of inferior turbinate reduction during rhinoseptoplasty in quality-of-life outcomes and nasal airway cross-sectional area.


METHODS
Randomized clinical trial.


METHODS
Individuals over 16 years with nasal obstruction, candidates to functional and aesthetics primary rhinoseptoplasty, were evaluated from December 2010 though January 2012 at a tertiary University Hospital, Brazil. Eligible participants were randomly allocated to rhinoseptoplasty with or inferior turbinate reduction through submucosal diathermy.


RESULTS
Relative changes ([postop-preop]/preop score) in specific (Nasal Obstruction Symptom Evaluation; NOSE) and general quality-of-life instruments (WHOQOL-bref), nasal obstruction visual analogue scale (NO-VAS) and nasal area measurements in acoustic rhinometry. OUTCOMES were blindly assessed 3 months postoperatively. Protocol was registered at ClinicalTrials.gov (NCT01457638).


RESULTS
50 patients were included, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32 ± 12 yr and 58% were female. Rhinoseptoplasty improved specific and general quality-of-life scores irrespective of turbinate intervention (P < 0.001).There was no difference between subjects submitted or not to inferior turbinate reduction in NOSE score (-75% vs. -73%; P = 0.893); all WHOQOL-bref score domains (P > 0.05), NO-VAS (-88% vs. -81%; P = 0.89) and acoustic rhinometry recordings (P > 0.05).During follow-up less patients in the rhinoplasty with inferior turbinate reduction group were using topical corticosteroids (6[24%] vs. 13[54%]; P = 0.03). Multivariable analyses, adjusting for postoperative topical corticosteroid use and previous nasal fracture, had no effect on these results.


CONCLUSIONS
Turbinate reduction through submucosal diathermy during primary rhinoseptoplasty did not improve short-term general and specific quality-of-life outcomes and acoustic rhinometry recordings. The role of turbinate reduction in sparing chronic corticosteroid use should be confirmed in long-term follow-up studies.
Graduate Program in Epidemiology,of Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil. mlavinsky@gmail.com
Michelle
M
Lavinsky-Wolff
Humberto Lopes
HL
Camargo
Carolina Rocha
CR
Barone
Luisi
L
Rabaioli
Fernando Herz
FH
Wolff
José Eduardo Lutaif
JE
Dolci
Carisi Anne
CA
Polanczyk
D000293:Adolescent; D000328:Adult; D002648:Child; D003972:Diathermy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D011788:Quality of Life; D023842:Rhinometry, Acoustic; D012225:Rhinoplasty / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery*; D055815:Young Adult