Computed Tomography Assessment of the Effect of Fluticasone Propionate Aqueous Nasal Spray Treatment on Inferior Turbinate Hypertrophy Versus Submucous Diathermy Needle Ablation
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- Category: Vol. 85, December 2017
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Computed Tomography Assessment of the Effect of Fluticasone Propionate Aqueous Nasal Spray Treatment on Inferior Turbinate Hypertrophy Versus Submucous Diathermy Needle Ablation, MOHAMED M. EL-SHEIKH
Abstract
Background: Hypertrophied inferior turbinates is one of the most common causes of nasal obstruction, a variety of medical and surgical treatments have been introduced for treating such a condition each with its benefits and dismerits, patients preference is an important issue to take into consid-eration in planning treatment for such condition with the general global thinking of avoiding invasive operative inter-vention with its complications and absenteeism from work, patient prefer conservative procedures or minimally invasive procedures to attain cure.
Objective: To study the effect of using intranasal flutica-sone propionate aqueous nasal spray on hypertrophied inferior nasal turbinate as regards outcome versus submucous diather-my using needle ablation as an office procedure using CT PNS coronal 2mm cuts bone window and office endoscopy.
Patients and Methods: 60 patients suffering solely from hypertrophied inferior turbinates were randomly selected to two groups; 30 patients were subjected to conservative medical treatment using fluticasone propionate 250 micrograms daily for three months and 30 patients were subjected to submucous diathermy of both inferior turbinate using local anesthesia and followed-up till 3 months post intervention, the turbinate grading system was used to analyze the patients pre and post intervention via office endoscopy (0 degree 4mm Hopkins endoscope) and CT PNS coronal cuts bone window and turbinate grade were recorded.
Results: Post treatment both groups showed highly sig-nificant reduction in turbinate size where Group A (submucous diathermy treatment) had 21 (70%) patients with Grade 1 inferior turbinate size and 9 (30%) patients with Grade 2 inferior turbinate size, on the other hand Group B (intranasal steroids treatment) had 2 (6.7%) patients with Grade 1 inferior turbinate size and 22 (73.3%) patients with Grade 2 inferior turbinate size, a comparison for effectiveness of both treatment revealed that Group A (submucous diathermy treatment) showed highly more significant reduction in turbinate size (p=<0.001) then Group B (intranasal steroids treatment) where Group A (submucous diathermy treatment) showed 12 (40%) patients showed 3 step downsizing of the inferior turbinate