SUBMUCOSAL DIATHERMY VS. COBLATION PARTIAL TURBINECTOMY ON NASAL MUCOCILIARY FUNCTION

Introduction: Mucociliary function is more important in the inferior turbinate than the other turbinates. Hypertrophy of the inferior turbinate is one of the commonest reason for chronic nasal obstruction. Mucociliary function is a vital defence mechanism that protects the respiratory system against microbes and alternative foreign particles. Nasal mucociliary function is either primarily or secondarily impaired within the majority of patients with repeated chronic rhinitis, sinusitis. A number of interventions are offered for the treatment of nasal obstruction secondary to inferior turbinate hypertrophy. An ideal procedure for turbinate reduction is one that ought to be related to least discomfort or adverse reactions and will preserve the physiological function of the turbinate, like control of humidification and temperature of the inspired air. Hence this study was done with the following aim Aim: The aim of this study is to evaluate nasal functions after treatment by submucosal diathermy and coblation partial turbinectomy on chronic nasal airway obstruction due to inferior turbinate hypertrophy. Methods: This study was started after obtaining the approval of Institutional Ethics Committee. Patients with unilateral or bilateral nasal block who visited the Department of Otorhinolaryngology, SMC&H, were screened. Of them, 72 patients with inferior turbinate hypertrophy as the cause for the nasal block had been recruited into the study after obtaining their written informed consent. All the patients were registered into the study during their first visit and all the patients were followed-up at 3 months and 6 months. The 72 patients who were recruited based on the inclusion and exclusion criteria were randomized using simple randomization into 2 treatment groups ie. Thirty six patients in group A ? submucosal diathermy and thirty six patients in group B ? coblation partial turbinectomy. A detailed history, examination and routine investigations were done on all the patients who were enrolled in the study. Nasal mucociliary function by saccharin test and Peak Nasal Inspiratory Flow Rate (PNIF) have been measured in all the patients before the surgery and at 3 months and 6 months post operatively. Results & Conclusion: Both the surgical techniques showed a statistically significant improvement in nasal mucociliary function and airway patency three months and 6 months post operatively. There was no statistically significant difference between the two surgical procedures. This suggests that both submucosal diathermy and coblation partial turbinectomy are equally effective in improving nasal mucociliary function and airway patency due to inferior turbinate hypertrophy.