COMPARE THE OUTCOMES OF PARTIAL RESECTION VS. PRESERVATION OF MIDDLE TURBINATE IN ENDOSCOPIC SINUS SURGERY CHRONIC RHINO-SINUSITIS

Abstract

Background: Chronic rhinosinusitis (CRS) remains a prevalent inflammatory disorder requiring functional endoscopic sinus surgery (FESS) when medical therapy fails. The role of the middle turbinate during FESS continues to be debated, particularly regarding whether partial resection or preservation offers better postoperative outcomes. Limited prospective evidence comparing these approaches has contributed to ongoing variation in surgical practice. Understanding the influence of middle turbinate management on symptom relief and surgical recovery is essential for optimizing patient outcomes in CRS.

Objective: To compare postoperative outcomes of partial middle turbinate resection versus preservation in patients undergoing FESS for chronic rhinosinusitis.

Methods: A randomized controlled trial was conducted including 102 adults aged 20–60 years diagnosed with CRS. Participants were allocated equally into two groups (51 each): FESS with middle turbinate resection and FESS with turbinate preservation. Preoperative clinical assessment included demographic parameters and baseline POSE scores. All surgeries were performed under standardized operative protocols. Postoperative POSE scores were recorded four weeks after surgery. Data analysis involved comparison of mean POSE score changes between groups using appropriate statistical tests, with significance set at p < 0.05.

Results: The mean age was 35.2 ± 10.1 years in the resection group and 36.5 ± 9.8 years in the preservation group. Males constituted 56.9% of the resection group and 52.9% of the preservation group. Mean BMI values were similar at 24.8 ± 2.5 kg/m² and 25.1 ± 2.7 kg/m², respectively. Mean preoperative POSE scores were 5.6 ± 1.2 for resection and 5.8 ± 1.3 for preservation. Postoperative POSE scores improved to 2.0 ± 0.8 in the resection group and 3.4 ± 1.1 in the preservation group. The mean POSE score reduction was 3.6 ± 1.4 for resection and 2.4 ± 1.5 for preservation, demonstrating a statistically significant difference between groups (p < 0.001).

Conclusion: Both middle turbinate resection and preservation were viable options during FESS; however, partial resection resulted in greater early postoperative improvement based on POSE scores. These findings support selective middle turbinate resection as a beneficial technique when performed with appropriate patient selection and surgical expertise.