DIAGNOSTIC NASAL ENDOSCOPIC FINDINGS (DNE) OF A PARTIAL MIDDLE TURBINATE RESECTION IN FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS)

Middle turbinate is a dynamic structure which is in a crucial position that plays a significant role in pathogenesis of rhinosinusitis and headache. The goal of treating sinus disease with surgery has evolved from removing all diseased sinus mucosa to specific exenteration of the tissue causing obstruction. Once ventilation is restored, it is postulated that the mucosa may regain near normal appearance and function. This study was conducted to evaluate and observe the benefits following partial middle turbinate resection during FESS on various symptoms of rhino sinusitis. METHODOLOGY: This is a random control trial. All the patients with chronic rhino sinusitis, was selected, studied, and subjected for FESS with partial middle turbinate resection for 50 patients and 50 patients subjected for FESS with middle turbinate preservation. All the patients were observed in post operative follow up for five months and the data was subjected for statistical analysis. RESULTS: In our study there was strongly significant p value of 0.000, 0.002, and 0.000 for edema, discharge and synechiae respectively and moderately significant p value of 0.047 for crusts with respect to DNE findings. In the patients with partial middle turbinate resection, the post operative DNE results also show improvement of 80% in edema, 40% in discharge, 40% in scarring, 30% in synechiae and 20% in crusts compared to the patients with preserved middle turbinate. CONCLUSION: Partial Middle turbinectomy appears to be a positive variable and an adjuvant technique in patients with inflammatory disease of paranasal sinus, in terms of the improvement and maintenance of ventilation of osteomeatal complex, especially if anatomical anomalies present. Partial middle turbinectomy is recommended whenever exposure is compromised.