Prognostic value of anterior rhinomanometry in diode laser turbinoplasty

abstract

Objective: Nasal obstruction is a common clinical problem. A variety of medical and surgical procedures have been described for the reduction of hyperplastic inferior nasal turbinates. Therefore objective criteria are helpful before deciding on a treatment. Study Design: prospective mono-centre tri...

al. Methods: Active anterior rhinomanometry with and without decongestion was used to assess forty-one patients with nasal obstruction due to hyperplastic inferior nasal turbinates 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 post-operative benefit. Results: Turbinoplasty significantly improved mean nasal airflow by 29.6%, from 509.8 cm3/s (SD 189.2 cm3/s) to 660.9 cm3/s (SD 285.4 cm3/s, p < 0.001). There is no significant correlation between patients´ subjective satisfaction and improvement of nasal airflow post-operatively (rs = -0.013; p = 0.93). There is a strong correlation between the pre-surgical effect of topical decongestion and the improvement of nasal airflow by surgery (rs = 0.416, p = 0.01). The correlation is even stronger when the absolute values are adjusted by the pre-operative nasal airflow baseline (rs = 0.549, p = 0.01). Conclusion: Rhinomanometry with topical decongestion has a high predictive value for the objective outcome of diode laser-assisted turbinoplasty. Using relative values adjusted by pre-operative nasal airflow baseline further improves this predictive value. 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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