How to prevent nasal obstruction after Rhinoseptoplasty. Could a routine turbinate reduction improve the outcomes in Quality of Life of patients?

Rhinoplasty is often performed to restore nasal function and form. The development or maintenance of nasal obstruction after rhinoplasty is a complication that negatively affects quality of life (QOL), and priority should be given to prevention strategies [1]. However, the available surgical techniques to prevent this obstruction have been empirically developed and are often used based on the surgeon’s preference rather than on objective criteria. Currently, strategies like spreaders grafts, support grafts, reconstruction or repositioning cartilages and even a good septoplasty are used to enlarge the nasal valve [2-6]. Another technique widely used is the Reduction of the inferior turbinate [3,7-9]. Otherwise, an established technique to reduce turbinate with hypertrophy is still debatable [10-13]. Reviews pointed that research in this field appears to be driven by technological advancement rather than by establishment of patientsʹ benefit. Partly, because of the lack of properly conducted randomized controlled trial with long term results. Some articles even question the efficacy of this procedure in cases of nasal obstruction explained for other reasons rather than turbinate hypertrophy isolated [14]. A Recent clinical trial reveal that the association of turbinectomy with septoplasty, though widespread, does not improve the nasal obstruction clinical outcomes and can add risks to patients [15].