Trial Comparing Microdebrider-Assisted Inferior Turbinoplasty (MAIT) vs Submucous Resection (SMR)

Study Overview
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Brief Summary
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This is a prospective, patient blinded, randomized, clinical trial enrolling patients with symptoms and signs of nasal obstruction related to enlarged inferior turbinates. The purpose of this study is to compare two different surgical methods, both of which are already in common use, for the treatment of nasal obstruction in patients with inferior turbinate hypertrophy.

Official Title
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Prospective Randomized Trial Comparing Microdebrider-Assisted Inferior Turbinoplasty (MAIT) vs Submucous Resection (SMR)

Conditions
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Nasal Obstruction

Intervention / Treatment
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* Procedure: Microdebrider-Assisted Inferior Turbinoplasty (MAIT)
* Procedure: Submucous Resection with non powered instrument


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Symptoms of chronic nasal obstruction with an exam finding of turbinate hypertrophy, with or without septal deviation will be eligible for the study. Failed medical treatment Have failed medical treatment for at least 1 month, and will be offered surgery Patients having Septoplasty at the same time as their turbinate reduction surgery. Exclusion Criteria: Patients who have had previous turbinate reduction surgery will be excluded. Patients that have nasal polyps, chronic rhinosinusitis, adenoid hypertrophy, nasal tumors, or any other exam finding that would explain their symptoms of nasal obstruction other than enlarged inferior turbinates with or without septal deviation will be excluded. Patients who are diagnosed with purely bony inferior turbinate hypertrophy as discussed below. Patients on hormone or anticoagulation therapy and those who have a history of head and neck radiation therapy will be excluded. All study candidates will be assessed for external nasal valve collapse via the modified Cottle maneuver, and will be excluded if they exhibit significant external or internal nasal valve collapse as their primary cause of their nasal obstruction. All patients will complete the Visual Analog Scale (VAS) on nasal obstruction before and after decongestion at their preoperative visit. Patients that fail to report a score less than 5 after decongestion are likely to have bony rather than soft tissue hypertrophy. In these patients MAIT is unlikely to be an adequate surgical option, and they would derive a greater amount of benefit from SMR. Therefore these patients will be excluded from the study, and offered only SMR.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Microdebrider-Assisted Inferior Turbinoplasty (MAIT)<br>Turbinoplasty using microdebrider turbinate blade (2.9mm inferior turbinate blade, Medtronic, 5000 Hz) | Procedure: Microdebrider-Assisted Inferior Turbinoplasty (MAIT)<br> <br> * Other names: Medtronic;|
| Experimental: Submucous Resection (SMR)<br>Turbinoplasty using non-powered instruments | Procedure: Submucous Resection with non powered instrument<br> <br> * Other names: Jansen-Middleton or straight through cut;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Nasal Obstruction Symptom Evaluation (NOSE) Score in MAIT vs SMR treated patients |  | 3 years post-operative | 
| Measure of pain on the Visual Analog Scale |  | 3 years post-operative |