Abstract
Background Inferior turbinate hypertrophy is a major cause of chronic nasal obstruction, significantly impairing nasal airflow and overall quality of life. Although medical management with antihistamines, decongestants, and corticosteroids is the first line of treatment, a subset of patients remains symptomatic and requires surgical intervention. Various surgical techniques, like mucosal sparing and non-mucosal sparing techniques, have become available recently. Microdebrider-assisted turbinoplasty (MAT) and coblation-assisted turbinoplasty (CAT) are two widely used mucosa-sparing techniques. However, limited comparative studies exist evaluating their efficacy, safety, and long-term outcomes. This study aims to compare the clinical outcomes of MAT and CAT in the surgical management of inferior turbinate hypertrophy. Methods This prospective comparative study included 60 patients diagnosed with symptomatic inferior turbinate hypertrophy unresponsive to medical therapy. Patients were assigned to undergo either MAT (n=30) or CAT (n=30) under general anesthesia using a lottery system. While the CAT group underwent controlled radiofrequency ablation with a coblator wand prior to outfracturing the turbinate, the MAT group underwent submucosal tissue removal and turbinate lateralization using a microdebrider. Postoperative outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) score and objective airflow measurements at the seventh day, second, and third months following surgery. Additionally evaluated were intraoperative time, bleeding, complications, and postoperative healing. Results Both MAT and CAT showed significant improvements in NOSE scores, with mean scores improving from 72.4 ± 8.6 preoperatively to 18.7 ± 4.2 at three months in the MAT group and from 73.1 ± 7.9 to 19.3 ± 5.1 in the CAT group; however, there is no statistical difference between the two procedures in terms of symptomatic relief (p > 0.05). Peak nasal inspiratory flow (PNIF) improved by 62.3% in the MAT group and 58.7% in the CAT group at three months (p > 0.05). Intraoperative blood loss was slightly lower in the CAT group (21.5 ± 5.2 mL vs. 27.8 ± 6.4 mL in MAT, p < 0.05). Postoperative crusting and healing times were comparable between the two groups, with no significant difference in complication rates or recurrence of turbinate hypertrophy. Conclusion MAT and CAT are both effective and safe surgical options for managing inferior turbinate hypertrophy. While CAT offers a slight advantage in intraoperative hemostasis, both techniques provide comparable symptom relief, nasal airflow improvement, and mucosal preservation, making either a viable choice based on surgeon preference and patient-specific factors.