BiZact-Assisted Endoscopic Resection of a Sinonasal Tumor.

The BiZact device, a bipolar electrosurgical scissor designed for tonsillectomy, minimizes thermal tissue damage and seals blood vessels <3 mm in diameter while dividing the soft tissue. This study describes the authors' experience with sinonasal tumor surgery using a BiZact and discusses its clinical utility and advantages. The authors analyzed BiZact-assisted endoscopic sinonasal tumor surgery cases between January 2021 and May 2023. Data were collected on patients' demographics, histopathology, extent of tumor involvement, surgical records, and postoperative medical records. Clinical utility was assessed using the success rate of complete tumor excision, estimated blood loss during surgery, device-related complications, and operation time. A survey of the surgeons' BiZact experience was also conducted. The diagnoses of the 20 patients in this study included squamous cell carcinoma (n = 2), malignant melanoma (n = 1), sarcoma (n = 1), natural killer cell lymphoma (n = 1), inverted papilloma (n = 12), angiofibroma (n = 2), and schwannoma (n = 1). This pilot study demonstrated a shortened operative time, with a median of 0.8 hours and <100 mL of intraoperative blood loss. In addition, no BiZact-related complications were observed. The BiZact device allows efficient sinonasal surgery because it has the unique advantage of one-step sealing and cutting. BiZact-assisted endoscopic sinonasal tumor surgery is a beneficial and safe procedure that reduces blood loss during surgery, shortens the operative time, and minimizes postoperative complications.

Deep learning algorithm for the automated detection and classification of nasal cavity mass in nasal endoscopic images.

Nasal endoscopy is routinely performed to distinguish the pathological types of masses. There is a lack of studies on deep learning algorithms for discriminating a wide range of endoscopic nasal cavity mass lesions. Therefore, we aimed to develop an endoscopic-examination-based deep learning model to detect and classify nasal cavity mass lesions, including nasal polyps (NPs), benign tumors, and malignant tumors. The clinical feasibility of the model was evaluated by comparing the results to those of manual assessment. Biopsy-confirmed nasal endoscopic images were obtained from 17 hospitals in South Korea. Here, 400 images were used for the test set. The training and validation datasets consisted of 149,043 normal nasal cavity, 311,043 NP, 9,271 benign tumor, and 5,323 malignant tumor lesion images. The proposed Xception architecture achieved an overall accuracy of 0.792 with the following class accuracies on the test set: normal = 0.978 ± 0.016, NP = 0.790 ± 0.016, benign = 0.708 ± 0.100, and malignant = 0.698 ± 0.116. With an average area under the receiver operating characteristic curve (AUC) of 0.947, the AUC values and F1 score were highest in the order of normal, NP, malignant tumor, and benign tumor classes. The classification performances of the proposed model were comparable with those of manual assessment in the normal and NP classes. The proposed model outperformed manual assessment in the benign and malignant tumor classes (sensitivities of 0.708 ± 0.100 vs. 0.549 ± 0.172, 0.698 ± 0.116 vs. 0.518 ± 0.153, respectively). In urgent (malignant) versus nonurgent binary predictions, the deep learning model achieved superior diagnostic accuracy. The developed model based on endoscopic images achieved satisfactory performance in classifying four classes of nasal cavity mass lesions, namely normal, NP, benign tumor, and malignant tumor. The developed model can therefore be used to screen nasal cavity lesions accurately and rapidly.

The deubiquitinase UCHL3 mediates p300-dependent chemokine signaling in alveolar type II cells to promote pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a chronic, fatal, fibrotic, interstitial lung disease of unknown cause. Despite extensive studies, the underlying mechanisms of IPF development remain unknown. Here, we found that p300 was upregulated in multiple epithelial cells in lung samples from patients with IPF and mouse models of lung fibrosis. Lung fibrosis was significantly diminished by the alveolar type II (ATII) cell-specific deletion of the p300 gene. Moreover, we found that ubiquitin C-terminal hydrolase L3 (UCHL3)-mediated deubiquitination of p300 led to the transcriptional activation of the chemokines Ccl2, Ccl7, and Ccl12 through the cooperative action of p300 and C/EBPß, which consequently promoted M2 macrophage polarization. Selective blockade of p300 activity in ATII cells resulted in the reprogramming of M2 macrophages into antifibrotic macrophages. These findings demonstrate a pivotal role for p300 in the development of lung fibrosis and suggest that p300 could serve as a promising target for IPF treatment.

Platelet-rich plasma injection for empty nose syndrome: A case report.

Empty nose syndrome (ENS) is a relatively rare disease found in patients who have undergone sinonasal surgery, characterized by excessive reduction of the turbinate, causing intranasal turbulence and loss of receptors within the nasal mucosa. Patients diagnosed with the disease usually experience symptoms including dryness of the nose, nasal pain, paradoxical nasal obstruction, and crusts in the nasal cavity. ENS can be treated with conservative care such as nasal irrigation or nasal moisturizers. Accurate efficacy of surgical treatment of ENS is often difficult to predict and is accompanied by operational obstacles and complications. Platelet-rich plasma (PRP) has recently gained attention as a regenerative therapy in several medical fields. We present two cases of ENS treated by injection of PRP as a simple and less invasive method, and describe its efficacy with nasal endoscopy and subjective questionnaires.

Therapeutic effects of selective p300 histone acetyl-transferase inhibitor on liver fibrosis.

Liver fibrosis is caused by chronic liver damage and results in the aberrant accumulation of extracellular matrix during disease progression. Despite the identification of the HAT enzyme p300 as a major factor for liver fibrosis, the development of therapeutic agents targeting the regulation of p300 has not been reported. We validated a novel p300 inhibitor (A6) on the improvement of liver fibrosis using two mouse models, mice on a choline-deficient high-fat diet and thioacetamide-treated mice. We demonstrated that pathological hall-marks of liver fibrosis were significantly diminished by A6 treatment through Masson's trichrome and Sirius red staining on liver tissue and found that A6 treatment reduced the expression of matricellular protein genes. We further showed that A6 treatment improved liver fibrosis by reducing the stability of p300 protein via disruption of p300 binding to AKT. Our findings suggest that targeting p300 through the specific inhibitor A6 has potential as a major therapeutic avenue for treating liver fibrosis. [BMB Reports 2023; 56(2): 114-119].

Palatopharyngeal muscle suspension suture technique for patients with obstructive sleep apnea.

PURPOSE: Palatal surgery remains a major option for patients with obstructive sleep apnea (OSA). We sought to evaluate the therapeutic outcomes of the palatopharyngeal muscle suspension suture technique (PSST) as a novel palatal surgery for patients with OSA. MATERIALS AND METHODS: Of the 816 patients who underwent polysomnography (PSG) from February 1, 2017, to June 30, 2020, 30 patients with OSA who underwent PSST were retrospectively reviewed. The medical records of the patients were also recorded. Among the 30 patients with OSA, nine who underwent preoperative and postoperative PSG were analyzed. RESULTS: Of the 30 patients with OSA, 28 (93.3 %) were male. The mean (SD, standard deviation) age was 43.3 (12.7) years, and the mean (SD) body mass index was 27.3 (3.2). As objective parameters, the mean (SD) apnea-hypopnea index was significantly decreased from 45.9 (21.20) to 29.03 (21.62) (p < 0.05) and the mean (SD) lowest oxygen saturation improved significantly from 77.6 % (7.14 %) to 84.6 (5.17 %) (p < 0.05). As a subjective parameter, the mean (SD) Epworth Sleepiness Scale score decreased significantly from 10 (4.95) to 6.9 (4.57) (p < 0.05), and the mean (SD) visual analog scale score for snoring decreased significantly from 6.3 (1.8) to 3.1 (1.9) (p < 0.001). No complications, such as upper airway obstruction, intractable postoperative bleeding, or velopharyngeal insufficiency, were observed in any of the patients postoperatively. CONCLUSIONS: A novel palatal surgery, PSST, has numerous advantages as a useful surgical option for patients with OSA. It is minimally invasive, easy, time-saving, and relatively reversible.

Solitary Sphenoid Sinus Lesion Presenting as Chronic Headache.

BACKGROUND AND OBJECTIVES: Headache is a common symptom with etiologies that are difficult to distinguish, 1 of which is sinusitis. A solitary sphenoid lesion, which is rare, can also cause acute or chronic headaches. The authors investigated whether endoscopic sinus surgery (ESS) for solitary sphenoid lesions could reduce headache symptoms. SUBJECTS AND METHODS: The authors reviewed the charts of patients who underwent ESS from 2012 to 2017, whose main symptom was a chronic headache for several years. There were no remarkable pathologic findings in the nasal cavity upon endoscopic examination. Medications for reducing headaches had transient effect. Brain magnetic resonance imaging or computed tomography scans showed a solitary sphenoid lesion and the patients underwent ESS by the same otolaryngologist. In total, 16 out of 547 ESS cases that met the above conditions were included in this study. The authors evaluated the duration, character, and degree of the headaches pre- and post-operatively. The authors also determined if there was a correlation between headaches, sphenoidal lesions, and pathologic outcomes. RESULTS: There were significant improvements in headaches after surgery. The pre- and post-operative mean visual analog scale score for headaches was 7.27 ±â€Š1.67 and 3.80 ±â€Š1.82, respectively. The pathologic outcomes revealed chronic inflammation in 11 patients, nasal polyp in 1 patient, inverted papilloma in 1 patient, and fungal infections in 3 patients, but there was no clinical correlation between the headache, lesion site, and pathology. CONCLUSIONS: A solitary sphenoid lesion can be the cause of acute or chronic headaches. Headaches from a solitary sphenoid sinus lesion, which were not controlled by medical treatments, could be improved by surgical procedures.

Comparing reliability between 3D imaging and 2D photography for external nasal anthropometry.

This study investigates and compares the reliability and reproducibility of two facial anthropometric methods about external nasal angles, 3D imaging and conventional 2D photography. 2D photograph images and 3D images about external nose of 30 volunteers were taken using digital camera and Morpheus 3D scanner. To evaluate intra-rater reliability, each images were taken over two different days for each subject by the same researcher. To evaluate inter-rater reliability, another researcher took each images for each subject on the first day. The reliability of each method for measuring 4 external nasal angle is obtained using intraclass correlation coefficient (ICC) and compared. Inter-rater and intra-rater reliability of both 3D imaging and 2D photography had excellent agreement in all 4 nasal angles. In the nasofacial angular parameter, Inter-rater ICC, 2D photography was significantly higher than 3D imaging. Result of intra-rater ICC also showed both 3D imaging and 2D photography had good reliability in all 4 nasal angles. Similar to those of inter-rater ICC, nasofacial angular parameter showed statistically significant differences between 3D imaging and 2D photography. In terms of reliability, both 2D and 3D showed appropriate anthropometric results and considering its own advantage, each methods can be used complementarily.

Aucuparin Suppresses Bleomycin-Induced Pulmonary Fibrosis Via Anti-Inflammatory Activity.

Idiopathic pulmonary fibrosis (IPF) is a lung disease that results in scarring of the lungs for an unknown reason. Although many studies have been conducted on IPF, precise mechanisms and treatments have not yet been identified. In this study, we found that aucuparin, a natural product isolated from Sorbus aucuparia, inhibited pulmonary fibrosis in a bleomycin (BLM)-induced lung fibrosis mouse model. In the lung samples of mice treated with aucuparin, the gene expression of inflammation and macrophage activation markers was reduced compared to those treated with BLM alone. Moreover, aucuparin decreased the expression of profibrotic marker genes and increased the expression of antifibrotic marker genes. Finally, we observed that aucuparin significantly suppressed transforming growth factor-ß-induced activation of inflammatory cytokine production and collagen synthesis from macrophages and fibroblasts, respectively. Taken together, these data demonstrate that aucuparin inhibits lung fibrosis via its anti-inflammatory action and support its potential to be a therapeutic drug for IPF treatment.

The Degree of Stress in Patients With Empty Nose Syndrome, Compared With Chronic Rhinosinusitis and Allergic Rhinitis.

BACKGROUND: Depression is a mental health disease of growing public health concern because depressive mood affects the sufferer's daily life and is also associated with productivity decline. Depression that is caused by other diseases or substances is referred to as secondary depression, which is an important distinction because curing the underlying cause could subsequently regulate depressive mood. Empty nose syndrome (ENS), also known as "paradoxical obstruction of the nose," is a condition in which the major symptom is difficulty breathing, despite having sufficient breathing space in the nose. Empty nose syndrome has been increasing in prevalence in Korea. We found that patients with this ENS have a tendency toward depressive mood, which can escalate so far as to lead to suicide attempts. Thus, herein, we aimed to investigate the psychological burden on patients with ENS. METHODS: We divided patients into 4 groups: ENS (group A), chronic rhinosinusitis with polyp (CRS c polyp, group B), chronic rhinosinusitis without polyp (CRS s polyp, group C), and allergic rhinitis (AR, group D). We estimated and compared Beck Depression Inventory (BDI) scores among the 4 groups, and we investigated the relationship between depression index and nasal cavity area in patients with ENS. RESULTS: The ENS group (A) had depression prevalence of 71% with varying severity, which was much higher than group B (19%), group C (15%), and group D (27%). The correlation between nasal cavity volume and BDI score for the ENS group was not statistically significant. CONCLUSION: The degree and severity of depression in patients with ENS was higher than in patients with CRS or AR. Furthermore, there was no relationship between depression severity and nasal cavity volume in the patients with ENS. Thus, physicians should be careful not to dismiss the accompanying mental health problems of patients with ENS.

Saddle Deformity After Septoplasty and Immediate Correction.

OBJECTIVE: The aim of this study is to assess the saddle deformity after septoplasty and the usefulness of immediate correction. DESIGN: Retrospective study. SETTING: University medical center. PATIENTS: Of 658 patients who underwent endonasal septoplasty from January 2011 to July 2018, 14 underwent immediate cartilage dorsal augmentations following septoplasty for saddle deformity and were enrolled in this study. MAIN OUTCOME MEASURES: A total of 14 patients received immediate cartilage augmentation and were followed for >3 months after surgery. External nose status, patterns of septal deformity, and surgical results were investigated with profile view photographs, paranasal sinus computed tomography scans, and nasal endoscopy. Symptom improvement was measured using the Nasal Obstruction Symptom Evaluation scale. RESULTS: All patients had middle to high site septal deviation. Anterior deviation and central deviation have statistical significance compared to posterior part deviation (P = 0.025, P = 0.002) and mid part deviation has statistical significance compared to basal part deviation (P = 0.005). Postoperative subjective nasal symptoms of the 14 patients were improved from preoperation (18.54 ±â€Š2.46) to 1 month (7.54 ±â€Š2.16) and 3 months (1.72 ±â€Š1.55) postoperatively. CONCLUSIONS: Immediate endonasal cartilage augmentation for iatrogenic saddle deformity after septoplasty is easy, safe, and effective. Furthermore, this corrective treatment for post op complication is very important for both of surgeon and patient. Predispositions to postoperative saddle deformity included site and severity of preoperative nasal septal deviation.

Cartilage Trap-Door Flap Technique for Correction of High Nasal Septum Deflection.

OBJECTIVE: To introduce a novel cartilage trap-door flap technique in endonasal septoplasty to correct high dorsal deviation of the cartilaginous septum, and confirm its effectiveness. DESIGN: Prospective observational study. SETTING: Medical center. METHODS: 46 patients who had underwent septoplasty using the cartilage island flap technique to correct the high dorsal deviation from November 2014 to November 2015. The subjective symptoms were measured using the Nasal Obstruction Symptom Evaluation scale. The objective evaluations of the surgical results were analyzed using acoustic rhinometry. Post-operative status of the nasal septum was estimated by nasal endoscopic examination. RESULTS: Among 46 patients, 32 cases (69.57%) were "complete correction", 14cases (30.43%) were "improved" with residual deviation and there was not "no-change" or "even worse" case based on endoscopic examination. Minimal cross-sectional area in convex side of nasal cavity was significantly changed from 0.22cm to 0.56cm after the surgery, and nasal volume in narrower side of nasal cavity was significantly changed from 2.44mL to 6.22 mL. The patients' nasal obstruction symptoms significantly reduced from 10.43 before the surgery to 1.45 after the surgery. During the follow-up period, the authors have not experienced any obvious complications such as saddle nose, septal perforation, and bleeding. CONCLUSION: The proposed cartilage trap-door flap technique provides easy and effective results for dorsal deviations of the cartilaginous septum in selected cases without significant complications.

A Comparison of Endoscopic Reduction for Medial Blowout Fractures Using a Bioresorbable Panel and Silastic Sheet.

BACKGROUND: The aim of the study was to compare the effectiveness of endoscopic endonasal reduction using a bioresorbable panel and silastic sheet packed with Merocel for blowout fractures of the medial orbital wall. DESIGN: Retrospective study. METHODS: The study group consisted of 147 patients who underwent endoscopic endonasal reduction of a blowout fracture of the medial orbital wall between January 2005 and December 2016. Fifty-seven fractures were repaired using a splint formed by a silastic sheet and Merocel (splint group), whereas 90 fractures were repaired using a bioresorbable panel for interposition (interposition group). Postoperative complications and surgical outcomes of the 2 groups were compared. RESULTS: Preoperative diplopia in both groups (n = 30) was resolved except 1 in interposition group after the reduction. Enophthalmos was resolved in 10 cases in the splint group and in 6 cases in the interposition group. In postoperative CT scans, 20 of the 57 cases in the splint group exhibited under- or overcorrection, compared with 9 of the 90 cases in the interposition group (P < 0.05). There were no sinus infections or implant-related side effects in the interposition group except for implant extrusion in 4 cases, whereas 7 cases developed sinusitis in the splint group (P < 0.05). CONCLUSIONS: Endonasal endoscopic reduction using a bioresorbable panel may be considered as a surgical alternative for the treatment of medial orbital blowout fractures.

Novel Application of Ultrasonic Bone Aspirator for Hump Nose.

OBJECTIVE: This study was conducted to introduce and evaluate the efficacy of an ultrasonic bony aspirator in rhinoplasty for hump removal. DESIGN: Retrospective study. SETTING: University medical center. PATIENTS: Twenty patients who underwent hump removal using an ultrasonic bone aspirator from October 2013 to November 2016 were enrolled in the study. MAIN OUTCOME MEASURES: Patients were followed for >3 months after surgery. External nose status and surgical results were investigated using photographs. Postoperative complications were evaluated. RESULTS: Of the 30 patients enrolled in this study, 11 were females and 19 were males. Preoperative nasal deformities of all patients were characterized as bony humps. Postoperative dorsal status was significantly improved. There were no obvious complications such as over or under correction, delayed healing, infection, soft tissue injury, or deformity of the nasal dorsum. CONCLUSION: Application of an ultrasonic bone aspirator to remove humps in rhinoplasty is easy, safe, and effective.

Use of a Balloon Catheter With Intraoperative C-Arm Fluoroscan for Reduction of Zygomatic Arch Fractures.

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the usefulness of C-arm fluoroscan with a balloon catheter in patients undergoing closed reduction of zygomatic arch fractures. SUBJECTS AND METHODS: All patients who had zygomatic arch reduction surgery between 2006 and 2015 were identified and classified into 2 groups. Group A included those patients who underwent closed reduction of zygomatic arch fractures. Group B included those who underwent zygomatic arch reduction surgery with a C-arm fluoroscan and supporting balloon. A balloon catheter was used to stabilize the zygomatic bone after reduction. Results were scored from 1 (poor) to 3 (good) to assess surgical outcomes based on 3 criteria: alignment of the zygomatic arch on a postoperative computed tomography scan, facial asymmetry in photography, and the patient's subjective satisfaction. RESULTS: The authors enrolled 32 patients with zygomatic arch fractures. 18 patients underwent closed reduction for zygomatic arch fractures (group A), while 14 patients underwent closed reduction with C-arm fluoroscan and balloon support (group B). The average score for group A was 2.00 for alignment, 2.56 for facial asymmetry, and 2.67 for subjective satisfaction compared with 2.64 for alignment, 2.86 for facial asymmetry, and 2.79 for subjective satisfaction in group B. There were statistically significant differences in the alignment and facial asymmetry scores between the 2 groups. CONCLUSION: The authors suggest that C-arm fluoroscan with balloon support is a useful modality for reduction of zygomatic arch fractures that provides better surgical outcomes than conventional closed reduction surgery.

Myoepithelioma of the Nasal Septum.

Myoepithelioma is defined as myoepithelial cells composed of tumor with solid, myxoid, and reticular growth pattern by the World Health Organization. It is a rare neoplasm that arises in the major salivary gland or minor salivary gland comprising approximately 1% of all salivary gland tumor. This neoplasm occurs in the parotid gland and soft palate mostly, which can be found in other organs. However, up to now, myoepithelioma of nasal septum has not been reported in English medical literature. Histologically, it is grouped as spindle, epitheliod, reticular, and clear cell types. Spindle cell type is the most common. In this case, a 40-year-old woman presented with complaining of nasal stuffiness and accidentally found right nasal cavity mass. Endoscopic surgery for excision of the mass was performed under local anesthesia, which was confirmed as myoepithelioma. After surgery, the patient's symptom was disappeared and there has not been sign of recurrence for 6 months. We present a rare patient of myoepithelioma of the nasal septum with review of relevant literature.

CT-Based Morphological Analysis of Isolated Inferior and Medial Blow-out Orbital Fractures in Korean Adults.

PURPOSE: To evaluate morphologic differences in isolated inferior medial orbital wall fractures (OWF) based on computed tomography scans. METHODS: This was a retrospective observational case study of 22 patients with an isolated inferior OWF and 32 patients with an isolated medial fracture between January 2008 and August 2010. We analyzed patient demographics and bony radiologic characteristics on CT scans, including the length and height of the lamina papyracea, the number of ethmoid air cell septa, the length of the anterior and posterior border of the orbital floor, the thickness of the orbital floor maxillary bone, and the axial length of the eyeball. RESULTS: There were no significant differences in sex, laterality, or concomitant intraocular injury between the two groups. The anteroposterior length (p = 0.391), the number of ethmoid septa (p = 0.869), and the thickness of the orbital floor (p = 0.419) did not differ significantly. The anterior (p < 0.001) or posterior (p = 0.014) height of the lamina papyracea, the lamina papyracea area (p < 0.001), and the lamina papyracea area/ethmoid air cell septa (p = 0.024) were significantly higher in the medial OWF group, while the anterior (p = 0.026) or posterior (p < 0.001) border length of the orbital floor and the axial length (p = 0.047) and volume (p = 0.034) of the eyeball were longer and smaller, respectively, in the inferior OWF group. CONCLUSIONS: Patients with a longer anterior or posterior border of the orbital floor, a shorter axial length, and a smaller eyeball volume are more likely to incur an isolated inferior OWF than an isolated medial OWF.

Transantral Orbital Floor Fracture Repair Using a Folded Silastic Tube.

OBJECTIVES: The purpose of this study was to evaluate the advantages and limitations of using a silicon tube to support the fractured orbital floor by a transantral approach. METHODS: A retrospective study was conducted from January 2000 to December. 2011 in 51 patients with pure orbital floor fractures. The patients underwent reduction surgery via a transantral approach for inserting a folded silastic tube to support the fractured orbital floor in the maxillary sinus. A chart review of preoperative and postoperative ocular symptoms, operation records, and complications was maintained. RESULTS: In 18 out of 25 patients with diplopia, postoperative improvement was seen. In 13 out of 15 patients with extraocular muscle limitation, postoperative improvement was seen. Enophthalmos resolved postoperatively in four of five patients. Postsurgical complications occurred in three patients: an overcorrection, an infection in the maxillary sinus, and an implant extrusion, all of which were resolved by revision surgeries. CONCLUSION: During the course of the study, we sensed reduction using a folded silastic tube via a transantral approach as an easy and effective technique with good postoperative results, and minimal implant related complications. This novel procedure is recommended as a surgical option for the reduction of orbital floor fractures.

The application of an ultrasonic bone aspirator for septoturbinoplasty.

OBJECTIVE: The objectives of this study were to introduce the use of an ultrasonic bone aspirator (UBA; SONOPET [Mutoh Co, Ltd, Tokyo, Japan]) for septoturbinoplasty and to evaluate the efficacy and usefulness of this surgical procedure. DESIGN: This was a retrospective chart review. SETTING: This study was performed at a university medical center. METHODS: Of the 53 patients who underwent septoturbinoplasty from July to October 2013, 30 were operated on using a UBA and were enrolled in this study. Patients were followed for more than 6 months after surgery. Patterns of septal deviation and surgical results and complications were investigated by paranasal sinus computed tomography scans, nasal endoscopy, and acoustic rhinometry. Improvement of symptoms was measured using the Nasal Obstruction Symptom Evaluation scale. RESULTS: Patterns of bony septal deviation were classified as follows: localized septal bony spur or crest (n = 7), basal bony septal deviation (n = 9), posterior bony septal deviation (n = 8), bony spur with basal part deviation (n = 5), and basal and posterior bony septal deviation (n = 1).Twenty-six patients underwent septoplasty with bilateral inferior turbinate reduction surgery using either a microdebrider (n = 10) or a microdebrider with UBA (n = 16). Four patients underwent septoplasty with unilateral turbinate reduction surgery using a microdebrider and UBA. Based on nasal endoscopic findings after surgery, 24 patients had a straight septum, whereas 6 exhibited minimal remaining curvature. Subjective symptoms of nasal obstruction evaluated using the visual analog scale and the Nasal Obstruction Symptom Evaluation scale were improved in all patients. Surgery using a UBA increased minimal cross-sectional area and nasal volume change in patients. There were no significant complications related to UBA use such as saddle nose, bleeding, or septal perforation. CONCLUSIONS: Application of a UBA for septo-turbinate surgery is an easy, safe, and effective method that reduces the occurrence of common complications, such as septal perforation, delayed healing, infection, and bleeding. In addition, the UBA produces minimal thermal and mechanical injury to surrounding tissue and enables precise and incremental bone removal with continuous irrigation and suction. This tool allows for easy sculpting and reduction of bony architecture of the nasal cavity.