Personalized Selection of Inferior Turbinate Surgery Based on Structural Phenotyping: A Structured Narrative Review...

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Innovation

Background:

• Inferior turbinate hypertrophy is a primary cause of chronic nasal obstruction.
• Current surgical decisions lack personalization based on specific anatomical and functional causes.
• A standardized classification and treatment algorithm for inferior turbinate hypertrophy are needed.

Purpose of the Study:

• To develop a classification system for inferior turbinate hypertrophy phenotypes.
• To create a decision algorithm linking these phenotypes to targeted surgical strategies.
• To support individualized treatment planning and shared decision-making in turbinate surgery.

Main Methods:

• A structured narrative review of PubMed and Scopus databases.
• Inclusion of studies on turbinate anatomy, pathology, imaging, grading, and surgical outcomes.
• Development of a four-phenotype classification and a clinical decision algorithm integrating endoscopy, functional testing, and CT imaging.

Main Results:

• Four phenotypes identified: mucosal, bony, anterior nasal valve-turbinate conflict, and mixed hypertrophy.
• Specific surgical techniques recommended for each phenotype (e.g., radiofrequency ablation for mucosal, powered turbinoplasty for bony).
• Algorithm designed to prevent mismatched treatments and guide personalized surgical selection.

Conclusions:

• A phenotype-guided algorithm offers a structured, evidence-based approach to personalized inferior turbinate surgery.
• Emphasizes mucosal preservation, anatomical specificity, and patient-centered decision-making.
• Aims to improve outcomes by avoiding inappropriate surgical interventions and guiding future research.