Inferior turbinate surgery and nasal airflow: evidence-based management

This review will discuss the evidence-based management of enlarged inferior turbinate by considering methods of assessing nasal airflow, controversies surrounding patient selection and surgical outcomes.

There is currently no consensus on patient selection for turbinate surgery. Patients are empirically offered surgery on the basis of subjective complaint of nasal obstruction and surgeon's clinical examination. Few authors have utilized objective measurements of nasal airflow such as rhinomanometry to select suitable patients for surgery. There is a small body of evidence suggesting that more robust criteria of selecting patients, using a nasal decongestant test and rhinomanometry, may have some influence on the surgical outcome. Although most surgical techniques demonstrate improvement in postoperative nasal airflow and subjective scores, it is impossible to draw conclusions as to which technique is best suited for treating inferior turbinate enlargement. The heterogeneous study cohorts, differing patient selection criteria and outcome measures used do not allow meta-analysis of outcomes and comparison between surgical techniques.

Inferior turbinate surgery is an evolving operative concept and the evidence supporting the efficacy of the various techniques remains undecided. More prospective controlled studies are needed with both objective and subjective outcome measures.