Conchopexy of middle turbinate Versus Bolgerization in Endoscopic Sinus Surgery..

Abstract

Background: Middle turbinate (MT) lateralization remains a frequent postoperative complication of functional endoscopic sinus surgery (FESS), potentially leading to synechiae, impaired ventilation, and surgical failure. This study aimed to compare the efficacy of Conchopexy and Bolgerization techniques in preventing MT lateralization and promoting postoperative healing.

Methods: A prospective comparative interventional study was conducted on 45 patients with chronic rhinosinusitis undergoing bilateral FESS at Rizgari Teaching Hospital from January to December 2023. Patients were randomized into two groups: Group A (Conchopexy, n = 23) underwent MT–septal fixation using an absorbable suture, while Group B (Bolgerization, n = 22) received controlled mucosal abrasion to create a synechia. The MT position and mucosal healing (POSE score) were assessed at 12 weeks postoperatively. Statistical analysis was performed using SPSS v27 with a significance level of p < 0.05.

Results: MT lateralization occurred in 13.1% of Conchopexy cases and 9.1% of Bolgerization cases (p = 0.67). The mean POSE score was 2.33 ± 1.17 for Conchopexy and 2.08 ± 1.43 for Bolgerization (p = 0.54), indicating comparable mucosal healing. No major complications or follow-up losses were reported.

Conclusion: Conchopexy and Bolgerization are equally safe and effective in maintaining MT medialization and supporting mucosal recovery following FESS. Bolgerization offers simplicity and shorter operative time, whereas Conchopexy provides secure fixation and mucosal preservation. The choice of technique should depend on intraoperative anatomy and surgeon preference.