Middle Turbinate Resection versus Preservation in Patients with Chronic Rhinosinusitis Accompanying Nasal Polyposis: Baseline Disease Burden and Surgical Outcomes between the Groups

Abstract

Objective: To evaluate baseline disease burden and surgical outcomes between middle turbinate resection and preservation groups consisting of patients diagnosed with chronic rhinosinusitis accompanying nasal polyposis (NP). Study Design: Prospective, nonrandomized study. Methods: The preoperative disease burden (extent of NP, Lund-Mackay scores, and subjective symptom scores) was evaluated using nasal endoscopy, computed tomography, and questionnaires. Objective and subjective surgical outcomes were assessed 12 months postoperatively based on endoscopic findings, the Sino-Nasal Outcome Test 20 (SNOT-20), and a visual analogue scale (VAS). Results: The extent of NP, Lund-Mackay scores, and VAS scores for the two main symptoms were significantly greater in the resection group than in the preservation group. The preservation group had better objective outcomes. Preoperative SNOT-20 and VAS scores were improved significantly at 12 months postoperatively in both groups, and the improvement did not differ significantly between the groups. Conclusions: The middle turbinate resection group had greater baseline disease burden (severe polyposis, more extensive disease, and poorer symptom scores) than the preservation group. This may be the reason for the poorer objective surgical outcome in the resection group despite more radical surgery. However, the subjective outcomes were successful regardless of the middle turbinate resection or preservation.