Turbinate-septal suture for middle turbinate medialization: a prospective randomized trial.

OBJECTIVES/HYPOTHESIS: One of the primary goals of endoscopic sinus surgery (ESS) is to create widely patent paranasal sinus ostia, but lateralization of the middle turbinate (MT) after ESS can obstruct otherwise patent ethmoid and maxillary sinuses. The aim of this study was to evaluate the effectiveness of turbinate-septal suturing in preventing lateralization of the MT.

STUDY DESIGN: A prospective, randomized, blinded controlled study.

METHODS: The study was performed in 120 patients who had undergone ESS. The patients were randomized to receive nasal (group A) or turbinate-septal suture plus nasal packing (group B). Postoperative lateralization of the MT and synechia formation were assessed as the primary outcome 3 months post-ESS. The Lund-Kennedy Scores at 1 week, 2 week, and 1 month after ESS were assessed as the secondary outcomes.

RESULTS: A total of 120 patients were enrolled (60 patients in each group). Group B had a significantly lower rate of MT lateralization compared to group A after 3 months of surgery (6 of 120 sides vs. 19 of 120 sides; P < 0.01). Synechia formation rates in groups B were also significantly lower than those in group A (4 of 120 sides vs. 13 of 120 sides; P = 0.023).

CONCLUSION: Middle turbinate-septal suturing medialization during ESS is an effective method for preventing lateralization of the MT.