Praxis of Otorhinolaryngology

Cengiz Arlı1, Saim Pamuk2

1Department of Otolaryngology, Kocaeli Health and Technology University, Medar Gölcük Hospital, Kocaeli, Türkiye

2Department of Otolaryngology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye

Keywords: Concha bullosa, crushing, endoscopic surgery, lateral resection, middle turbinate, NOSE score

Abstract

Objectives: This study aims to compare the effectiveness of endoscopic middle turbinate lateral resection and the crushing technique in patients undergoing surgery for concha bullosa (CB) using the Nasal Obstruction Symptom Evaluation (NOSE) scale.
Patients and Methods: This prospective study was performed on 60 patients who underwent surgery for isolated CB between March 2023 and February 2025. Patients were randomized into two groups according to the surgical technique: the conventional surgery group (16 males, 14 females; mean age: 39.2 ± 8.5 years; range, 18 to 60 years) and the crushing group (18 males, 12 females; mean age: 40.1 ± 7.8 years; range, 20 to 61 years). The NOSE scores were evaluated preoperatively and at the 6th postoperative month. Operative time and complications were recorded. A p-value < 0.05 was considered statistically significant.
Results: Both groups showed significant improvement in postoperative NOSE scores compared with preoperative values (p < 0.001). There was no significant difference between groups regarding symptom improvement (p > 0.05). The mean operative time was significantly shorter in the crushing group (5 ± 3 min) compared with the lateral resection group (23.4 ± 6 min) (p < 0.05). Synechiae occurred in four (13.3%) patients in the lateral resection group and seven (23.3%) patients in the crushing group. Recurrence was observed only in the crushing group (two patients, 6.7%). No major postoperative hemorrhage or cerebrospinal fluid leak was detected.
Conclusion: Both techniques provide comparable symptomatic improvement in CB surgery. The crushing technique offers the advantage of shorter operative time and may be considered an effective, minimally invasive alternative in appropriately selected patients.

Citation: Arlı C, Pamuk S. Is the crushing method really beneficial in concha bullosa surgery? Praxis Otorhinolaryngol 2026;14(3):179-183. https://doi.org/10.5606/ kbbu.2026.2.