Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T20:26:40.451Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of basal lamella relaxing incision and combined conventional medialisation and controlled synechiae in functional endoscopic sinus surgery: a randomised prospective study

Published online by Cambridge University Press:  02 July 2018

D D Maharaj ,
R S Virk ,
S Bansal  and
A K Gupta
D D Maharaj
Affiliation:
Department of ENT, Postgraduate Institute of Medical Education and Research (‘PGIMER’), Chandigarh, India
R S Virk*
Affiliation:
Department of ENT, Postgraduate Institute of Medical Education and Research (‘PGIMER’), Chandigarh, India
S Bansal
Affiliation:
Department of ENT, Postgraduate Institute of Medical Education and Research (‘PGIMER’), Chandigarh, India
A K Gupta
Affiliation:
Department of ENT, Postgraduate Institute of Medical Education and Research (‘PGIMER’), Chandigarh, India
*
Author for correspondence: Dr Ramandeep Singh Virk, Department of ENT, PGIMER, Sector 12, Chandigarh 160012, India Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To compare combined conventional Freer medialisation and controlled synechiae, performed for middle meatal access (during the initial steps of functional endoscopic sinus surgery) and post-operative middle turbinate medialisation, with basal lamella relaxing incision, the latter of which is a single step for achieving both middle meatal access and post-operative medialisation. The study also compared the effects of controlled synechiae and basal lamella relaxing incision on post-operative olfaction.

Method

A randomised prospective study was performed on 52 nasal cavity sides (32 patients). Only basal lamella relaxing incision was performed in one group, and both conventional medialisation and controlled synechiae were performed in the other. Intra-operative and post-operative photography was used to measure the middle meatal area. A pocket smell test was used to assess olfaction.

Results

There were no significant differences in operative middle meatal access and post-operative medialisation of the middle turbinate. Post-operative olfaction was affected more in the combined conventional medialisation and controlled synechiae group, compared to the basal lamella relaxing incision group, but this finding was not statistically significant.

Conclusion

Basal lamella relaxing incision is an effective single-step technique for achieving adequate middle meatal access and post-operative medialisation, with no significant effect on olfaction.

Keywords

Endoscopic Sinus SurgeryMiddle TurbinateOlfactionSynechiae
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 605 - 610
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr R S Virk takes responsibility for the integrity of the content of the paper

References

1Thornton, RS. Middle turbinate stabilization technique in endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1996;122:869–72Google Scholar
2Getz, AE, Hwang, PH. Basal lamella relaxing incision improves endoscopic middle meatal access. Int Forum Allergy Rhinol 2013;3:231–5Google Scholar
3Musy, PY, Kountakis, SE. Anatomic findings in patients undergoing revision endoscopic sinus surgery. Am J Otolaryngol 2004;25:418–22Google Scholar
4Lee, JY, Lee, SW. Preventing lateral synechia formation after endoscopic sinus surgery with a silastic sheet. Arch Otolaryngol Head Neck Surg 2007;133:776–9Google Scholar
5Bhalla, RK, Kaushik, V, de Carpentier, J. Conchopexy suture to prevent middle turbinate lateralisation and septal haematoma after endoscopic sinus surgery. Rhinology 2005;43:143–5Google Scholar
6Hewitt, KM, Orlandi, RR. Suture medialization of the middle turbinates during endoscopic sinus surgery. Ear Nose Throat J 2008;87:E11Google Scholar
7Bolger, WE, Kuhn, FA, Kennedy, DW. Middle turbinate stabilization after functional endoscopic sinus surgery: the controlled synechiae technique. Laryngoscope 1999;109:1852–3Google Scholar
8Friedman, M, Landsberg, R, Tanyeri, H. Middle turbinate medialization and preservation in endoscopic sinus surgery. Otolaryngol Neck Surg 2000;123:76–80Google Scholar
9Swanson, PB, Lanza, DC, Vining, EM, Kennedy, DW. The effect of middle turbinate resection upon the frontal sinus. Am J Rhinol 1995;9:191–5Google Scholar
10Moukarzel, N, Nehmé, A, Mansour, S, Yammine, FG, Moukheiber, A. Middle turbinate medialization technique in functional endoscopic sinus surgery. J Otolaryngol 2000;29:144–7Google Scholar
11Grisel, JJ, Atkins, JH, Fleming, DJ, Kuppersmith, RB. Clinical evaluation of a bioresorbable implant for medialization of the middle turbinate in sinus surgery. Int Forum Allergy Rhinol 2011;1:33–7Google Scholar
12Friedman, M, Tanyeri, H, Landsberg, R, Caldarelli, D. Effects of middle turbinate medialization on olfaction. Laryngoscope 1999;109:1442–5Google Scholar
13Galal, N, Metwally, B, Elfouly, M, Elmottaleb, MA. Post-operative evaluation of middle turbinate medialization versus basal lamella relaxing incision in endoscopic sinus surgery. Pan Arab J Rhinol 2014;4:2–7Google Scholar