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Modified Young's procedure: a forgotten procedure in rhinology

Sudhir M Naik Gautham MK Ravishankara S Sathya P Mohan Appaji Shankarnarayan Bhat Ravi Karumbiah Rudresh Hiremath

Background: Modified Young's procedure (MYP) was a popular procedure for primary atrophic rhinitis. The classical Young’s procedure was not tolerated well since its inception and a modification popularly known as the “Modified Young’s procedure” was introduced. The complete closure of the nostrils were not well tolerated as most of the patients disliked mouth breathing and also the nasal voice. Material and methods: We report a case series of MYP done in 17 cases of primary atrophic rhinitis under general anaesthesia. Bilateral procedures were done in all patients who tolerated it well. The polythene tube buttons were removed after 7 days. Results: Mean duration of follow up was 15.11 months, with good symptoms improvement. Recanalization was done in 6 cases with 3 cases had concurrent multisinusitis with severe headaches and CECT PNS confirming it. The 3 patients were operated with endoscopic sinus surgeries after recanalization with minimal decongestant measures and microdebrider drill to remove the sclerosed walls of the maxillary sinuses. Conclusion: Modified Young's procedure is a forgotten entity in rhinology as the incidences are decreasing and the modes of delivery of medications intranasally are becoming easier and compliant. However in resistant and noncompliant patients MYP with periodic nasal endoscopy can be very rewarding.