Relationship between inferior turbinate outfracture and the improvement of nasal ventilatory function

Objective To discuss the relationship between structural change in nasal cavity and the change of nasal ventilatory function after ouffracture of the inferior turbinate. Methods The inferior turbinate outfracture surgery was performed on 50 chronic hypertrophic rhinitis patients who suffered inferior turbinate hypertrophy according to endoscopy and CT scan. Preoperative and postoperative nasal endoscopy was carried out on all patients, by which the distance from the inferior turbinate front mucous membrane to nasal septum （DTNS） was measured. In addition, CT was used to measure the minimal distance between the inside edges of the bilateral inferior turbinate soft tissue （MDTT） and the minimal distance between the bilateral inferior turbinate bones （MDTB） at the central layer of coronal sectional infundibulum; the minimal distance between the inferior turbinate at asial nasal limen （NLDT）; inferior turbinate thickness （ITT）. In this way, the change in the structure of nasal cavity was evaluated. Acoustic rhinomctry and rhinomanometry were utilized to evaluate the ventilatory function of the nasal cavity objectively. Visual analogue scale （VAS） was applied to evaluate the severity of preoperative and postoperative nasal obstruction subiectively. The testdata were used to perform match t-test; Spearman rank correlation was adopted to evaluate the relationship between patients' bilateral VAS and nasal inspiratory effective resistance （IER）, nasal expiratory effective resistance （EER） and DTNS. The relationship between the total resistance of nasal inspiratory phase as well as the total resistance of nasal expiratory phase and MDT？ and MDTB was analyzed. SPSS 20.0 software was used to analyze the data. Results The preoperative data showed that rightward DTNS was （0.12 ± 0.07）cm, leftward DTNS was （0.10±0.07）cm and MDTr was （0.70±0.13）cm, and postoperative data showed that rightward DTNS was （0.47 ± 0.27 ）cm, leftward DTNS was （0.43±0.15）cm, and MDTT was （1.05±0.15）cm. Significant differences existed in rightward DTNS, leftward DTNS and MDTT between pre-and post operative data （t values were -8.827, -8.590, -17.525, all P < 0.05）. According to the preoperative and postoperative comparison, the difference in MDTB, NLDT, rightward ITT, leftward ITT, IER, EER, 0 -5 cm nasal cavity volume （0 -5 cm NCV） , nasal minimal cross-sectional area （NMCA）, rightward VAS and leftward VAS had statistical significance （t values were -23.562, -8.374, 8.693, 6.684, 12.021, 14.510, -6.074, -2.285, 14.042 and 9.925, respectively, all P < 0.05）. Patients' bilateral VAS grades had a positive relationship with IER and EER （left side： r values were 0.541 and 0.660, respectively, right side： r values were 0.940 and 0.688, respectively, all P < 0.05）. Additionally,patients' VAS had a negative relationship with DTNS （r value was -0.861, P < 0.05）. Besides,the total resistance of nasal inspiratory phase had a negative relationship with both MDTT and MDTB （r values were -0.565 and - 0.546, respectively, all P < 0.05）. The total resistance of nasal expiratory phase had a negative relationship with both MDTF and MDTB （r values were -0.562 and -0.546, all P < 0.05）. Conclusion The inferior turbinate ouffracture surgery was an ideal surgical method by which nasal cavity could be broadened and nasal ventilatory function improved. Key words: Turbinates; Otorhinolaryngologic surgical procedures; Nasal cavity; Rhinomanometry; Rhinometry, acoustic