Evidence map›Paper›PMID 42900199›Full record

ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Efficacy and safety of middle turbinate resection versus preservation during endoscopic sinus surgery in patients with chronic rhinosinusitis: a systematic review and meta-analysis.

Muath Abdullah Almaimoni, Jarallah Hamad Alghazi, Nawaf Ali H Alagrafy, Dema F Alharby, Abdullah Seraye Alseraye, Khalid Saleh A Alsuhaibany, Omar Ibrahim Alanazi, Sameer Al-Bahkaly

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In one paragraph

Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Muath Abdullah AlmaimoniCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia. almaimonimarnd@outlook.com.ORCID http://orcid.org/0009-0008-2361-3252
Jarallah Hamad AlghaziCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Nawaf Ali H AlagrafyCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Dema F AlharbyCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Abdullah Seraye AlserayeCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Khalid Saleh A AlsuhaibanyCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Omar Ibrahim AlanaziCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.
Sameer Al-BahkalyCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 13611, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic rhinosinusitis (CRS) is a common inflammatory disease that significantly impairs quality of life. When symptoms persist despite medical therapy, endoscopic sinus surgery (ESS) is performed. During ESS, whether to resect or preserve the middle turbinate remains controversial: resection may improve access and reduce postoperative obstruction, while preservation maintains anatomy and may support normal healing and airflow. Evidence comparing both approaches is limited and inconsistent, so their relative efficacy and safety remain unclear.

methodsA comprehensive literature search was conducted across various databases until January 2026 to identify relevant studies. The quality was assessed using the ROB2 and Newcastle-Ottawa Scale (NOS) tools and the analysis was performed using R software.

resultsThe search identified 4,265 records; after screening and full-text assessment, 31 studies were included. Compared with preservation, middle turbinate resection showed a statistically significant improvement in Lund-Kennedy endoscopic score (MD = - 0.58), while symptom improvement measured by SNOT showed no significant difference. Resection significantly reduced postoperative adhesion/synechiae (RR = 0.35) and sinus ostium restenosis (RR = 0.41). For secondary outcomes, olfaction and POSE scores did not differ significantly between groups, and crustation and middle meatal antrostomy patency were not significantly different. Postoperative bleeding risk was higher with resection (RR = 2.24), whereas lateralization (RR = 0.29) and polyp recurrence (RR = 0.58) were lower with resection.

conclusionMiddle turbinate resection during ESS for CRS appears to improve postoperative endoscopic healing and patency-related outcomes (including reduced synechiae and ostial restenosis), but it does not confer a consistent advantage in patient-reported symptoms and is associated with a higher risk of postoperative bleeding; therefore, MT management should be individualized and anatomy-/risk-guided rather than routine.

Indexed as

Chronic rhinosinusitisEndoscopic sinus surgeryLund–Kennedy endoscopic scoreMiddle turbinatePostoperative bleedingPreservationResectionSNOTSynechiae

Identifiers

PMID42900199

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.