Arch Otolaryngol Head Neck Surg 2010 Oct;136(10):1015-9
Department of Otorhinolaryngology, Friedrich-Schiller-Universität, Lessingstraße 2, D-07743 Jena, Germany.
Objective: To identify objective criteria predicting the success of diode laser-assisted turbinoplasty.
Design: Prospective before-and-after trial with follow-up of 8 weeks.
Setting: Outpatient department of a tertiary referral center.
Patients: Forty-one patients with nasal obstruction caused by hyperplastic inferior nasal turbinates.
Intervention: Active anterior rhinomanometry with and without decongestion was used to assess the patients both before and after diode laser-assisted turbinate surgery. Surgery was performed under local anesthesia in "contact mode" using a continuous diode laser. In addition, a questionnaire assessed the subjective postoperative benefit.
Main Outcome Measures: Presurgical effect of topical decongestion was correlated with postoperative improvement of nasal airflow and patients' subjective satisfaction.
Results: Turbinoplasty significantly improved the mean (SD) nasal airflow by 37.1% (52.4%) (95% confidence interval [CI], 20.6%-53.7%), from 509.8 (189.2) cm³/s (95% CI, 450.1-569.5) to 660.9 (285.4) cm³/s (95% CI, 570.8-751.0) (P < .001). There was no significant correlation between patients' subjective satisfaction and improvement of nasal airflow postoperatively (r(s) = -0.01; P = .93). There was a strong correlation between the presurgical effect of topical decongestion and the improvement of nasal airflow by surgery (r(s) = 0.42; P = .01). The correlation was even stronger when the absolute values were adjusted by the preoperative nasal airflow baseline (r(s) = 0.55; P = .01).
Conclusions: Rhinomanometry with topical decongestion has a high predictive value for the objective outcome of diode laser-assisted turbinoplasty. Thus, performing a rhinomanometry with topical decongestion and calculating the relative spread of decongestion can help to estimate the patients' benefit from diode laser-assisted turbinate surgery.