Conchopexy of middle turbinate versus bolgarization in endoscopic sinus surgery

Abstract

Abstract Objectives: The aim of this study is to assess the role of simple conchopexy suture in maintaining a widely patent middle meatus during the phase of postoperative healing (and its effect on olfaction); this enables delivery of topical medication and sinus aeration compared with functional endoscopic sinus surgery (ESS) with and without bolgarization of the middle turbinate (MT). Patients and methods: This study included 39 patients. Patients were divided into three equal groups randomly; each group included 13 patients. Group A underwent ESS with suture medialization of the MT (method), group B underwent ESS with bolgarization of the MT, and group C underwent normal ESS. Items of comparison between the three groups included both subjective and objective parameters such as symptoms (nasal obstruction, facial pain, and smell) and endoscopy findings. All the patients underwent preoperative and 2-month postoperative assessment with a questionnaire, smell test, and endoscopic examination. Results: In terms of nasal obstruction in all three groups, there was a statistically significant improvement (P = 0.001, 0.001, and 0.002, respectively). Improvement in facial pain was statistically highly significant in group A (P = 0.0007), whereas it improved significantly in groups B and C (P = 0.001 and 0.002, respectively). Improvement in smell was statistically insignificant in all three groups (P = 0.4). The postoperative endoscopy findings improved compared with the preoperative findings in all three groups. Conclusion: MT conchopexy and bolgarization of the MT have no detectable adverse effects on olfaction. No lateral synechia was detected, and there was a highly significant improvement in facial pain scores were observed in patients who underwent concopexy; patients who underwent middle turbinate bolgarization also showed improvement in both aspects, but in a lower percent. Both conchopexy and bolgarization of the MT after conventional ESS may help improve postoperative ostiomeatal complex patency, mucosal healing, and minimize adhesions, with no adverse effect on olfaction.