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Vol. 72. Issue 3.
Pages 170-176 (May - June 2021)
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Vol. 72. Issue 3.
Pages 170-176 (May - June 2021)
ARTÍCULO ORIGINAL
Inferior nasal turbinate mucosa shrinkage prior to surgery under local anaesthesia
Descongestión de la mucosa del cornete nasal inferior antes de la cirugía bajo anestesia local
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Olaf Zagólskia,
Corresponding author
olafzag@gmail.com

Corresponding author.
, Paweł Strękb, Małgorzata Lisieckac, Przemyslaw Gorzedowskid
a Department of Otorhinolaryngology, St. John Grande's Hospital, Kraków, Poland
b Department of Otorhinolaryngology, Collegium Medicum, Jagiellonian University, Kraków, Poland
c Intensive Care Unit, St. John Grande's Hospital, Kraków, Poland
d General Medical Practice, Kaiserslautern, Germany
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Table 1. Differences between the sums of the distances from the nasal septum to the medial rim of the lower nasal turbinate during the examination entering the patients for turbinoplasty and at the beginning of the surgical procedure in the group of 130 participants operated on under local anaesthesia.
Abstract
Introduction and Objectives

Chronic rhinitis-related complaints may result from isolated hypertrophy of the inferior nasal turbinates. If the symptoms persist despite conservative management, turbinoplasty is indicated. However, the nasal mucosa lining the inferior turbinates seems decongested immediately before the surgery performed under local anaesthesia, compared to the examination when the patients were entered for surgery. The study aimed to confirm this observation and to hypothesize as to the reasons for its occurrence.

Patients and Methods

The measurements of the longest distances between the medial rim of the inferior nasal turbinate mucosa and nasal septum and the shortest distances between the lower rim of the turbinate and floor of the nasal cavity in the inferior part of both common nasal meatus, were carried out on photos taken during endoscopic examinations: the one entering the patient for turbinoplasty, and the other immediately before the procedure. The results in this group were compared to those obtained from patients operated on under general anaesthesia.

Results

In 130 patients aged 18-60 (mean=40.7) years, operated on under local anaesthesia, the sum of the mean distances between the nasal septum and the medial rim of the lower turbinate in both nasal cavities, was 3.4mm during the first examination, and 4.5mm (p=.0008) during the second one. In the group of 42 participants aged 26-47, mean=36.8 years operated on under general anaesthesia, the values were: 4.8mm and 3.6mm (p=.02), respectively. The differences were significantly smaller in the smokers (.3) compared to non-smokers (1.3; p=.04) mm.

Conclusions

Records of the entering examination must be considered before turbinoplasty under local anaesthesia.

Keywords:
Nose
Sinusitis
Turbinates
Endoscopy
Abbreviations:
AR
CGRP
CR
CRS
CT
EPOS
INTs
NSE
NPY
SP
VIP
Resumen
Introducción y objetivos

Las molestias relacionadas con la rinitis crónica pueden ser resultado de la hipertrofia aislada de los cornetes nasales inferiores. Si los síntomas persisten a pesar del tratamiento conservador, está indicada la turbinoplastia. Sin embargo, la mucosa nasal que recubre los cornetes inferiores parece descongestionarse inmediatamente antes de la cirugía realizada con anestesia local, en comparación con el examen realizado al ingresar los pacientes para cirugía. El estudio tuvo como objetivo confirmar esta observación y formular hipótesis sobre las razones de su ocurrencia.

Pacientes y métodos

Se realizaron mediciones de las distancias más largas entre el borde medial de la mucosa del cornete nasal inferior y el tabique nasal, así como las distancias más cortas entre el borde inferior del cornete y el suelo de la cavidad nasal en la parte inferior de ambos meatos nasales comunes, en las fotografías tomadas durante los exámenes endoscópicos: las realizadas al ingresar el paciente para turbinoplastia y las realizadas inmediatamente antes del procedimiento. Los resultados en este grupo se compararon con los obtenidos en pacientes operados bajo anestesia general.

Resultados

En 130 pacientes de 18 a 60 años (media = 40,7) años, operados bajo anestesia local, la suma de las distancias medias entre el tabique nasal y el borde medio del cornete inferior en ambas cavidades nasales fue de 3,4 mm durante el primer examen, y 4,5 mm (p = 0,0008) durante el segundo. En el grupo de 42 participantes de 26 a 47 años, promedio = 36,8 años operados bajo anestesia general, los valores fueron: 4,8 mm y 3,6 mm (p = 0,02), respectivamente. Las diferencias fueron significativamente menores en los fumadores (0,3) en comparación con los no fumadores 1,3 mm (p = 0,04).

Conclusiones

Deben considerarse los registros del examen realizado durante el ingreso previo a la turbinoplastia bajo anestesia local.

Palabras clave:
Nariz
Sinusitis
Cornetes
Endoscopia

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