Medial Flap Versus Coblation-Assisted Turbinoplasty For Turbinates Hypertrophy: A Prospective Randomized Controlled Trial.

Abstract

Inferior turbinate (IT) hypertrophy is a common cause of nasal obstruction. Surgical intervention may be required when medical treatment fails. This study compares the long-term efficacy of medial-flap turbinoplasty (MFT) and coblation-assisted turbinoplasty (CAT) in patients with persistent nasal obstruction. A prospective, randomized controlled trial. Otolaryngology department-hospital and ambulatory clinics. Patients with IT hypertrophy who were surgical candidates were assigned to undergo either MFT or CAT. Symptom severity was assessed using the NOSE scale and VAS for nasal obstruction at baseline and at 1, 3, 6, and 12 months postoperatively. Secondary outcomes included endoscopic assessment of turbinate size, postoperative complications, and pain. Outcome examiners were blinded to the surgical technique. Forty-four patients completed the study (MFT: 21; CAT: 23). Both groups showed significant symptom improvement at all time points (P < .0001). While early outcomes were similar, the MFT group demonstrated significantly greater long-term symptom relief at 12 months (NOSE: 18.5 vs 34.5, P = .027; VAS: 2.2 vs 4.0, P = .043). MFT also showed greater turbinate size reduction (P < .001) and was associated with significantly less postoperative crusting. Pain scores and recovery times were comparable between groups. Both MFT and CAT are effective in improving nasal breathing in patients with IT hypertrophy. However, MFT demonstrated superior long-term outcomes and fewer complications, supporting this technique in appropriately selected patients.