Prognostic value of anterior rhinomanometry in diode laser turbinoplasty.

Authors:
Gerd Fabian Volk
Gerd Fabian Volk
Jena University Hospital
Germany
Mira Pantel
Mira Pantel
University Hospital
Orlando Guntinas-Lichius
Orlando Guntinas-Lichius
Jena University Hospital
Germany
Claus Wittekindt
Claus Wittekindt
University Hospital Giessen and Marburg

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.

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http://dx.doi.org/10.1001/archoto.2010.161DOI Listing

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October 2010
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