Evaluation of the Outcome of the Middle Turbinate Medialization (Fixation to Nasal Septum) by Various Surgical Technique

The primary objectives and essential aspects of ESS are to facilitate the proper drainage and ventilation of the afflicted groups of paranasal sinuses. The size and location of the middle turbinate directly impact the drainage of all paranasal sinuses. A prospective study has been conducted in the otolaryngology department at Al-Imamain Al-kadhmain teaching hospital from September 2021 to May 2023 on 180 selected patients, divided into three groups; each contains sixty patients with the following specific surgical intervention: group I: medialization of the middle turbinate only, group II: medialization of the middle turbinate with fixation to the nasal septum, and group III: medialization of the middle turbinate with fixation to the nasal septum by trans-septal sutures. Postoperatively, follow-up was done weekly during the 1st month and every 2 weeks during the 2nd month by assessing symptom improvement and nasal endoscopic findings. The findings showed that one hundred (55.6%) patients were males and eighty (44.4%) patients were females. The patients' ages varied from 20 to 48 years (mean ± SD = (33.45 ± 8.95) years). Post-operative improvement of presenting symptoms in order of sequence from higher to lower were as follows: nasal obstructions (74%), nasal discharge (74%), facial pain (70%), smell disorders (61%), and headache (53%). The current study concluded that the technique of middle turbinate medialization promotes effective drainage and ventilation, allowing for long-term monitoring and post-surgical suction clearing. Although it has its limits, the suturing method of the middle turbinate (conchopexy) is an efficient technique for preventing lateralization of the middle turbinate. This method has demonstrated superior overall outcomes when compared to iatrogenic adhesion (Bolgerization).