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  • Title: Effect of turbinate surgery in rhinoseptoplasty on quality-of-life and acoustic rhinometry outcomes: a randomized clinical trial.
    Author: Lavinsky-Wolff M, Camargo HL, Barone CR, Rabaioli L, Wolff FH, Dolci JE, Polanczyk CA.
    Journal: Laryngoscope; 2013 Jan; 123(1):82-9. PubMed ID: 23070968.
    Abstract:
    OBJECTIVES/HYPOTHESIS: To evaluate the role of inferior turbinate reduction during rhinoseptoplasty in quality-of-life outcomes and nasal airway cross-sectional area. STUDY DESIGN: 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. OUTCOMES: 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.
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