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European Archives of Oto-Rhino-Laryngology

Erschienen in:

02.01.2021 | Rhinology

Autonomic reflex effect of the inferior turbinate outfracture or bipolar cauterization inferior turbinate reduction surgery

verfasst von: Fuat Bulut, Erdem Soztutar

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2021

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Abstract

Purpose

To compare the autonomic reflexes caused by inferior turbinate outfracture or bipolar cauterization for inferior turbinate reduction surgery.

Methods

The investigators designed and implemented a prospective study composed of 80 patients who underwent a septoplasty with inferior turbinate reduction. The predictor variable was the type of bilateral reduction operation and included inferior turbinate outfracture with a freer elevator and 20 watts bipolar cauterization for 15 s per side after septoplasty. The primary outcome variable was the intraoperative changes of the heart rate monitored preoperatively and 20 s, 1 min, and 4 min after the turbinate reduction procedure. Other variables were systolic and diastolic blood pressure alterations after the inferior turbinate outfracture or bipolar cauterization procedure. Descriptive and bivariate statistics were computed and the P-value was set at .05.

Results

The sample was composed of 160 procedures in 80 patients grouped as follows: Outfracture (n = 100) and Cauterization (n = 60). There were no significant differences between the ages; grades of the turbinate hypertrophy; preoperative heart rates; and intraoperative 4th-minute heart rates, systolic and diastolic blood pressures. However, baseline systolic (p < 0.001) and diastolic (p < 0.001) blood pressures of the bipolar cauterization group were higher than outfracture group. Bipolar cauterization did not cause any significant changes in the heart rate, systolic and diastolic blood pressures. Inferior turbinate outfracture procedure caused a significant increase in heart rate (65.4 ± 9.82, p < 0.001), systolic (103 ± 8.62, p < 0.001) and diastolic (63.5 ± 7.37, p < 0.001) blood pressures.

Conclusion

The results of this study suggest that during the inferior turbinate outfracture procedure, it is important to closely monitor sympathetic and parasympathetic reflexes. The surgeon, and anesthesiologist, must be aware of the early stages of the autonomic reflexes during turbinate reduction.

Dawes PJD (1987) The early complications of inferior turbinectomy. J Laryngol Otol. https://doi.org/10.1017/S002221510010338XCrossRefPubMed

Nurse LA, Duncavage JA (2009) Surgery of the inferior and middle turbinates. Otolaryngol Clin N Am. https://doi.org/10.1016/j.otc.2009.01.009CrossRef

Hegazy HM, ElBadawey MR, Behery A (2014) Inferior turbinate reduction; coblation versus microdebrider. A prospective, randomised study. Rhinology. https://doi.org/10.4193/Rhino13.183CrossRefPubMed

White M, Rebeiz E (2020) Office-based inferior turbinate reduction using bipolar cautery: technique and results. Am J Otolaryngol Head Neck Med Surg. https://doi.org/10.1016/j.amjoto.2020.102449CrossRef

Berger G, Balum-Azim M, Ophir D (2003) The normal inferior turbinate: histomorphometric analysis and clinical implications. Laryngoscope. https://doi.org/10.1097/00005537-200307000-00015CrossRefPubMed

Sahin-Yilmaz A, Naclerio RM (2011) Anatomy and physiology of the upper airway. Proc Am Thorac Soc. https://doi.org/10.1513/pats.201007-050RNCrossRefPubMed

Smith DH, Brook CD, Virani S, Platt MP (2018) The inferior turbinate: an autonomic organ. Am J Otolaryngol Head Neck Med Surg. https://doi.org/10.1016/j.amjoto.2018.08.009CrossRef

Loehrl TA (2005) Autonomic function and dysfunction of the nose and sinuses. Otolaryngol Clin N Am. https://doi.org/10.1016/j.otc.2005.08.004CrossRef

Baxandall ML, Thorn JL (1988) The nasocardiac reflex. Anaesthesia. https://doi.org/10.1111/j.1365-2044.1988.tb06637.xCrossRefPubMed

10.

Betlejewski S, Betlejewski A, Burduk D, Owczarek A (2003) Nasal-cardiac reflex. Otolaryngol Pol 57(5):613–618PubMed

11.

Haldar R, Kaur J, Bajwa SJS (2015) Nasocardiac reflex during aspiration and injection through a nasogastric tube: an infrequent occurrence. Indian J Crit Care Med. https://doi.org/10.4103/0972-5229.154574CrossRefPubMedPubMedCentral

12.

Acar B, Yavuz B, Karabulut H et al (2010) Parasympathetic overactivity in patients with nasal septum deformities. Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-009-1055-zCrossRefPubMed

13.

Shearer ES, Wenstone R (1987) Bradycardia during elevation of zygomatic fractures: a variation of the oculocardiac reflex. Anaesthesia. https://doi.org/10.1111/j.1365-2044.1987.tb05231.xCrossRefPubMed

14.

Precious DS, Skulsky FG (1990) Cardiac dysrhythmias complicating maxillofacial surgery. Int J Oral Maxillofac Surg. https://doi.org/10.1016/S0901-5027(05)80420-5CrossRefPubMed

15.

Matarasso A (1989) The oculocardiac reflex in blepharoplasty surgery. Plast Reconstr Surg. https://doi.org/10.1097/00006534-198902000-00006CrossRefPubMed

16.

Campbell R, Rodrigo C, Cheung L (1994) Asystole and bradycardia during maxillofacial surgery. Anesth Prog. https://doi.org/10.1016/0278-2391(95)90254-6CrossRefPubMedPubMedCentral

17.

Baraniuk JN, Silver PB, Kaliner MA, Barnes PJ (1992) Neuropeptide Y is a vasoconstrictor in human nasal mucosa. J Appl Physiol. https://doi.org/10.1152/jappl.1992.73.5.1867CrossRefPubMed

18.

Wang HW, Kao CH, Chu YH (2006) A new in vitro method of decongestant assay of nasal mucosa: a preliminary report. Am J Rhinol. https://doi.org/10.1177/194589240602000109CrossRefPubMed

19.

Riederer A, Knipping S, Toleti B (2002) Regulation of the swelling mechanism in the inferior turbinate of human nasal mucosa. Laryngorhinootologie. https://doi.org/10.1055/s-2002-33292CrossRefPubMed

20.

Friedman M, Tanyeri H, Lim J, Landsberg R, Caldarelli D (1999) A safe, alternative technique for inferior turbinate reduction. Laryngoscope. https://doi.org/10.1097/00005537-199911000-00021CrossRefPubMed

21.

Wengraf C (1993) Concho-antropexy or total inferior turbinectomy for hypertrophy of the inferior turbinates? A prospective randomized study. J Laryngol Otol. https://doi.org/10.1017/S0022215100125460CrossRefPubMed

22.

Forsyth RD, Cole P, Shephard RJ (1983) Exercise and nasal patency. J Appl Physiol Respir Environ Exerc Physiol. https://doi.org/10.1152/jappl.1983.55.3.860CrossRefPubMed

23.

Lemaitre F, Chowdhury T, Schaller B (2015) The trigeminocardiac reflex. A comparison with the diving reflex in humans. Arch Med Sci. https://doi.org/10.5114/aoms.2015.50974CrossRefPubMedPubMedCentral

24.

Lang S, Lanigan DT, van der Wal M (1991) Trigeminocardiac reflexes: maxillary and mandibular variants of the oculocardiac reflex. Can J Anaesth. https://doi.org/10.1007/BF03008454CrossRefPubMed

25.

Robideaux V (1978) Oculocardiac reflex caused by midfacedisimpaction. Anesthesiology. https://doi.org/10.1097/00000542-197812000-00011CrossRefPubMed

26.

Yorgancilar E, Gun R, Yildirim M, Bakir S, Akkus Z, Topcu I (2012) Determination of trigeminocardiac reflex during rhinoplasty. Int J Oral Maxillofac Surg. https://doi.org/10.1016/j.ijom.2011.12.025CrossRefPubMed

27.

Bohluli B, Bayat M, Sarkarat F, Moradi B, Tabrizi MHS, Sadr-Eshkevari P (2010) Trigeminocardiac reflex during le Fort I osteotomy: a case-crossover study. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. https://doi.org/10.1016/j.tripleo.2009.12.054CrossRef

28.

Uddman R, Luts A, Sundler F (1985) Occurrence and distribution of calcitonin gene-related peptide in the mammalian respiratory tract and middle ear. Cell Tissue Res. https://doi.org/10.1007/BF00214575CrossRefPubMed

29.

Tank AW, Wong DL (2015) Peripheral and central effects of circulating catecholamines. Compr Physiol. https://doi.org/10.1002/cphy.c140007CrossRefPubMed

30.

Beloeil H, Mazoit JX, Benhamou D, Duranteau J (2005) Norepinephrine kinetics and dynamics in septic shock and trauma patients. Br J Anaesth. https://doi.org/10.1093/bja/aei259CrossRefPubMed

31.

Esler M, Willett I, Leonard P et al (1984) Plasma noradrenaline kinetics in humans. J Auton Nerv Syst. https://doi.org/10.1016/0165-1838(84)90071-7CrossRefPubMed

32.

Sinno S, Mehta K, Lee ZH, Kidwai S, Saadeh PB, Lee MR (2016) Inferior turbinate hypertrophy in rhinoplasty: systematic review of surgical techniques. Plast Reconstr Surg. https://doi.org/10.1097/PRS.0000000000002433CrossRefPubMed

33.

Barnard NA, Bainton R (1990) Bradycardia and the trigeminal nerve. J Cranio-Maxillofac Surg. https://doi.org/10.1016/S1010-5182(05)80056-3CrossRef

34.

Roberts RS, Best JA, Shapiro RD (1999) Trigeminocardiac reflex during temporomandibular joint arthroscopy: report of a case. J Oral Maxillofac Surg. https://doi.org/10.1016/S0278-2391(99)90829-7CrossRefPubMed

Titel: Autonomic reflex effect of the inferior turbinate outfracture or bipolar cauterization inferior turbinate reduction surgery
verfasst von: Fuat Bulut
Erdem Soztutar
Publikationsdatum: 02.01.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2021
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06508-4

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Springer Medizin

Autonomic reflex effect of the inferior turbinate outfracture or bipolar cauterization inferior turbinate reduction surgery

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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