Endoscopic Submucosal Resection Turbinoplasty VS Turbinectomy

NCT ID: NCT06310083

Last Updated: 2024-03-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-01

Study Completion Date

2024-01-31

Brief Summary

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The aim of our study is to compare endoscopic submucosal resection Turbinoplasty and partial inferior turbinectomy regarding clinical and radiological evaluation and its possible complications in the treatment of Chronic inferior turbinate hypertrophy.

Detailed Description

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The inferior turbinate (IT) plays a vital function in nose physiology by regulating the temperature and humidity of inhaled air and filtering foreign particles through the mucociliary clearance system.

One of the most common manifestations of chronic rhinitis is nasal obstruction. Nasal obstruction occurs as a result of submucosal or mucosal hypertrophy associated with increased vascularity of the inferior turbinate.

The location, size, and vasoactive capabilities of the inferior turbinate relegate it as a key player in airway resistance. Multiple pathologic processes may alter the gross and microscopic structure of the inferior turbinates, including septal deviation and inflammatory disorders such as allergic rhinitis, nonallergic rhinitis, and chronic rhinosinusitis. These disorders in turn lead to histological differences in terms of hypertrophy and hyperplasia, distorted cilia, inflammatory cell infiltrates, and mucosal thickening with subsequent macroscopic changes and symptomatic obstruction.

Surgical reduction of the inferior turbinate is warranted to relieve the nasal block caused by the hypertrophied inferior turbinates. Surgical reduction of the inferior turbinate involves removal of the mucosa, soft erectile tissue, and turbinate bone. Different techniques have been applied to increase the nasal airway passage, such as conventional turbinectomy, laser turbinectomy, cryoturbinectomy, electrocautery turbinectomy, conventional Turbinoplasty, microdebrider Turbinoplasty, coblation Turbinoplasty, radiofrequency Turbinoplasty, and ultrasound Turbinoplasty. Conventional turbinectomy (total or partial) is considered very effective in relieving nasal block. Due to the excessive loss of tissue (bone and mucosa), the postoperative complications include excessive bleeding requiring blood transfusion, crusting, pain, and prolonged recovery period. Hence, a more mucosal-friendly approach is preferred; the Turbinoplasty procedure, which resects either soft tissue or bone or both with preservation of the mucosa.

Conventional Turbinoplasty is designed to remove the nonfunctional obstructive part of the turbinate while preserving the functional medial mucosa, which plays the key role in the warming and humidification of air through the nasal passages. Performed endoscopically, inferior Turbinoplasty has the advantage over the other turbinate procedures by preserving sufficient mucosa, while removing adequate obstructed tissue to improve the airway significantly. The other term used for this technique is "submucosal resection", as a reference to its submucosal dissection procedure.

Conditions

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Turbinate; Hypertrophy Mucous Membrane

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A total of 40 patients were enrolled in the study. The patients were randomly classified into two groups, with 20 in each group.

Group A (study group): who applied for Endoscopic submucosal resection Turbinoplasty.

Group B (control group): Who applied for partial inferior turbinectomy.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The surgeons performed the nasal surgery and evaluating postoperative measurable outcomes was blinded about cases who were subjected to Endoscopic submucosal resection Turbinoplasty

Study Groups

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Submucosal Rescetion Turbinoplasty

participants in this group were applied for Endoscopic submucosal resection Turbinoplasty

Group Type ACTIVE_COMPARATOR

Submucosal Resection Turbinoplasty Versus Partial Inferior Turbinectomy

Intervention Type PROCEDURE

The study's Participants Were Randomly classified in two groups Interventional Group, applied for Submucosal Resection Turbinoplasty and the controlled group who were applied for Partial Inferior Turbinectomy

Partial Inferior Turbinectomy

participants in this group were applied for Partial Inferior Turbinectomy

Group Type PLACEBO_COMPARATOR

Submucosal Resection Turbinoplasty Versus Partial Inferior Turbinectomy

Intervention Type PROCEDURE

The study's Participants Were Randomly classified in two groups Interventional Group, applied for Submucosal Resection Turbinoplasty and the controlled group who were applied for Partial Inferior Turbinectomy

Interventions

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Submucosal Resection Turbinoplasty Versus Partial Inferior Turbinectomy

The study's Participants Were Randomly classified in two groups Interventional Group, applied for Submucosal Resection Turbinoplasty and the controlled group who were applied for Partial Inferior Turbinectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients aged between 18 and 45 years complaining with a minimum 3-month duration of nasal obstruction combined with clinical findings of inferior turbinate hypertrophy

Exclusion Criteria

1. Patient's Hemoglobin levels are less than 10gm%.
2. Patients who were Presented with acute upper respiratory tract infection.
3. Patients with other causes of nasal obstruction, e.g.,- allergic nasal polyposis, deviated nasal septum.
4. Patients who have nasal tumors.
5. Patients who had nasal operations before
6. Presence of bleeding disorder.
7. Presence of uncontrolled systemic disease.
8. During the period of menses
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ahmed Nabil Selim

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Nabil Selim

Lecturer of otorhinolaryngology

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Sabry H Easa, MD

Role: STUDY_CHAIR

Al-Azhar University Hospital of Assiut

Locations

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Al-Azhar University Hospital of Assiut

Asyut, , Egypt

Site Status

Countries

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Egypt

References

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Al Awad, M. K., & Ali, M. Y. (2022). Inferior Turbinate Hypertrophy Histopathology in Allergic Rhinitis Patients and in Patients with Deviated Nasal Septum. Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 23(23). https://doi.org/10.21608/ejentas.2022.141170.1518

Reference Type BACKGROUND

Abdullah B, Singh S. Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies. Int J Environ Res Public Health. 2021 Mar 26;18(7):3441. doi: 10.3390/ijerph18073441.

Reference Type BACKGROUND
PMID: 33810309 (View on PubMed)

Thamboo, A., Ayoub, N., Maul, X., & Nayak, J. (2021a). The Inferior Turbinate: Role in Normal Respiration and Airway Obstruction. In Current Otorhinolaryngology Reports (Vol. 9, Issue 4, 98 pp. 383-388). Springer Science and Business Media B.V. https://doi.org/10.1007/s40136-021- 00370-6

Reference Type BACKGROUND

Lee KC, Cho JM, Kim SK, Lim KR, Lee SY, Park SS. The Efficacy of Coblator in Turbinoplasty. Arch Craniofac Surg. 2017 Jun;18(2):82-88. doi: 10.7181/acfs.2017.18.2.82. Epub 2017 Jun 26.

Reference Type BACKGROUND
PMID: 28913312 (View on PubMed)

Elshipli NA, El-Sisi HE, El-Fattah AMA, Al-Saddeik MAE. Outcome comparison of submucous resection versus combined submucous diathermy and outfracture for treatment of inferior turbinate hypertrophy. Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3827-3837. doi: 10.1007/s00405-021-06663-2. Epub 2021 Feb 13.

Reference Type RESULT
PMID: 33582852 (View on PubMed)

Thirugnanamani, R., Sahadevan, S., Ramabhadraiah, A. K., Menon P, A., & M Prabhu, R. (2021). Benefits of Turbinectomy vs Turbinoplasty - A Prospective Study. Bengal Journal of Otolaryngology and Head Neck Surgery, 29(2). https://doi.org/10.47210/bjohns.2021.v29i2.435

Reference Type RESULT

Amhimmid, R. H., Mohamed, W., Amin, B., Mohamed, A. M., & Odabasha, A. E. (2022). Endoscopic Inferior Turbinoplasty Versus Radiofrequency Ablation for Treatment of Inferior Turbinate Hypertrophy. In The Egyptian Journal of Hospital Medicine (Vol. 88). https://ejhm.journals.ekb.eg/

Reference Type RESULT

Lund VJ, Kennedy DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl. 1995 Oct;167:17-21.

Reference Type RESULT
PMID: 7574265 (View on PubMed)

Easa SH, Farghaly TM, Elswaby ESS, Selim A. Endoscopic Submucosal Resection Turbinoplasty and Partial Inferior Turbinectomy for Management of Inferior Turbinate Hypertrophy: A Randomized Clinical Trial. Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5080-5090. doi: 10.1007/s12070-024-04926-y. Epub 2024 Aug 8.

Reference Type DERIVED
PMID: 39559133 (View on PubMed)

Other Identifiers

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SMR for Turbinate Hypertrophy

Identifier Type: -

Identifier Source: org_study_id

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