Effectiveness of Volumetric Reduction of Middle Concha Bullosa by Crushing Technique in Chronic Nasal Obstruction
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ORIGINAL ARTICLE
Effectiveness of Volumetric Reduction of Middle Concha Bullosa by Crushing Technique in Chronic Nasal Obstruction Narendra B. Suratwala1
•
Jay N. Suratwala2 • H. D. Jadawala3
Received: 20 May 2020 / Accepted: 8 August 2020 Association of Otolaryngologists of India 2020
Abstract To study the effectiveness of volumetric reduction of middle concha bullosa by crushing technique in chronic nasal obstruction cases on selection basis of 3Dimensional computed tomography measurements. Patients with complains of nasal obstruction underwent an Observational study. They were subjected to nasal endoscopy and computed tomography of paranasal sinuses with 3D size estimation of middle turbinate to confirm concha bullosa. 37 patients with unilateral/bilateral lesions were divided into 4 groups on the basis of ranged sizes. These were subjected to volume reduction by crushing technique with marsulizer under local/general anesthesia with necessary post-operative medications and the final outcomes were judged on basis for nasal endoscopy and computed tomography of paranasal sinus at 1 year. Out of 37 patients with total 42 concha bullosa, 5 had bilateral lesion. After crushing techniques, following results were obtained. In group A with pre-operative volume of concha between 0.60 and 0.80 ccm, 11 succeeded to achieve post-operative value of \ 0.60 ccm. In group B, C, D with preoperative concha volume [ 0.80 ccm all succeeded in achieving the post-operative value of \ 0.60 ccm. 50% reduction in volume of concha occurred in 88% cases of group A and
& Narendra B. Suratwala [email protected] 1
VAV Care Clinic and Sarvoday Hospital, Haripura, Pirchadi Road, Surat 395009, India
2
Sarvoday Hospital, Surat, India
3
VNSG University, Surat, India
100% in cases of other groups post-operatively at 1 year. Encouraging results with negligible consequences are ensued upon in case of chronic nasal obstruction due to concha bullosa by doing its volumetric reduction by crushing technique with marsulizer instrument. Keywords Concha bullosa (CB) Volumetric reduction (VR) Crushing technique Nasal obstruction
Introduction Pneumatization of middle turbinate is known as concha bullosa is fairly a common occurrence. On reviewing the literature the incidence between 14 and 40% is found. C.B. is a radiological diagnosis [1] and is often an incidental finding on computed tomography. It is usually an asymptomatic one requiring no treatment. Yet some situations, may warrant surgical correction of it. Conventional radiology does not permit a detailed study of the nasal cavity and paranasal sinuses, and has now largely been replaced by computerised tomographic (CT) imaging [2]. This gives an applied anatomical view of the region and the anatomical variants that are very often found. C.B. is best diagnosed on computed tomography. Not only the anatomy but also the patho-physiology of C.B. has been studied in detail. Middle turbinate regulates nasal airflow in parabolic fashion, while limiting medially it protects middle meatus
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