Turbinate Reduction in Endoscopic Surgery for Allergic Fungal Sinusitis: A Comparative Study

Abstract Background: Proper eradication of allergic fungal sinusitis (AFS) depends on three factors: First is proper preoperative evaluation and mapping via computed tomography and MRI. Second is the availability of adequate surgical tools in expe-rienced hands. Third is the proper postoperative endoscopic follow-up to detect and remove recurrence if possible. Aim of Study: To evaluate the role of inferior turbinectomy (IT) and partial middle turbinectomy (PMT) in patients with AFS managed by endoscopic sinus surgery (ESS) for the prevention of recurrence and adequate management of residual disease (postoperative salvage). Subjects and Methods: A prospective, comparative, ran-domized study conducted from February 2017 to January 2019. In all, 32 patients suffering from AFS were included. All patients have been presented and managed at the Depart-ment of Otolaryngology, Hearing and Speech Institute. Patients have been randomized into two groups of 16 patients each (groups A and B). The patients in group A have undergone ESS only, while the patients in group B have undergone ESS plus bilateral IT and PMT. Regular follow-up visits were done every 2 months for at least 6 months for both groups. Results: In group A, there was difficulty in proper assess-ment in 12 patients out of 16. Recurrence occurred in seven patients who showed rigorous assessment, which was managed via ESS adding to the maneuver bilateral IT and PMT. In group B, only two patients were difficult out of the 16. Recurrence occurred in three patients only and was managed easily in the outpatient office. No significant complications were detected in both groups. Conclusion: IT and PMT may be considered as essential steps in the surgery for AFS as they play a role in lowering the recurrence rate and facilitating better, more comfortable, and more effective postoperative management of recurrence if happened.