Nasal Obstruction Outcomes in Medial Flap Turbinoplasty and Inferior Turbinate Submucous Resection.

Abstract

To compare longitudinal improvement in nasal obstruction quality-of-life outcomes between medial flap turbinoplasty (MFT) and inferior turbinate submucous resection (SMR) concurrently performed with functional septorhinoplasty. Retrospective review of a prospectively collected cohort of patients undergoing functional septorhinoplasty between 2015 and 2022 at a tertiary academic center. Outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire preoperatively and over 12 months postoperatively. 373 patients were analyzed with longitudinal NOSE questionnaires. Of these, 298 underwent SMR and 75 underwent MFT. The proportion of concurrent intraoperative techniques including rim graft, spreader graft, auto-spreader graft, intradomal sutures, interdomal sutures, and alar spanning sutures were not significantly different between the two cohorts. Patients in all surgical groups had a statistically and clinically significant improvement in NOSE scores between their preoperative and postoperative follow-up visits (p < 0.001). MFT patients had higher NOSE scores 1 month postoperatively (40.0 ± 30.5 vs. 31.0 ± 27.97; p = 0.017), but lower scores after 10 months (15.2 ± 13.3 vs. 25.4 ± 23.5; p = 0.036). Similarly, patients in the MFT cohort in primary rhinoplasty procedures reported higher scores initially but lower after 10 months (p = 0.024). Men in the MFT cohort reported significantly better NOSE outcomes than the SMR cohort as early as 4 months post-surgery and sustained this improvement longitudinally throughout the follow-up period (10.6 ± 12.3 vs. 22.6 ± 21.4; p = 0.012). MFT and SMR offer beneficial long-term nasal breathing outcomes among patients undergoing functional rhinoplasty, though further study in appropriate patient selection is indicated. 3 Laryngoscope, 135:1983-1988, 2025.