- Original article
- Open Access
Conchopexy of middle turbinate versus bolgarization in endoscopic sinus surgery
The Egyptian Journal of Otolaryngology volume 31, pages219–223(2015)
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.
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.
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.
Hewitt KM, Orlandi RR. Suture medialization of the middle turbinates during endoscopic sinus surgery. Ear Nose Throat J 2008; 87: E11.
Friedman M. Middle turbinate medialization with bovine serum albumin tissue adhesive (BioGlue Department of Otolaryngology — Head and Neck Surgery. California: University of California-Irvine Medical Center, Orange; 2007. 4. 307–309.
Friedman M, Landsberg R, Tanyeri H. Middle turbinate medialization and preservation in endoscopic sinus surgery. Otolaryngol Head Neck Surg 2000; 123(Pt 1):76–80.
Friedman M, Tanyeri H, Landsberg R, Caldarelli D. Effects of middle turbinate medialization on olfaction. Laryngoscope 1999; 109: 1442–1445.
Thornton RS. Middle turbinate stabilization technique in endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1996; 122: 869–872.
Kim ST, Chung YS, Choi JH, Jeon HG, Ko SH, Cha HE, Han GC. Middle turbinate stabilization after endoscopic sinus surgery:The suture technique. Korean J Otolaryngol Head Neck Surg 2003; 46: 309–312.
Chen W, Wang Y, Bi Y, Chen W. Turbinate-septal suture for middle turbinate medialization: a prospective randomized trial. Laryngoscope 2015; 125: 33–35.
Dutton JM Hinton MJ. Middle turbinate suture conchopexy during endoscopic sinus surgery does not impair olfaction. Am J Rhinol Allergy. 2011; 25:125–127.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
About this article
Cite this article
Hegazy, M.A., Shawky, A., El Fouly, M.S. et al. Conchopexy of middle turbinate versus bolgarization in endoscopic sinus surgery. Egypt J Otolaryngol 31, 219–223 (2015). https://doi.org/10.4103/1012-5574.168316
- middle turbinate suturing