EVALUATION OF PARTIAL MIDDLE TURBINATE RESECTION DURING FUNCTIONAL ENDOSCOPIC SINUS SURGERY
Hossam M. Abdel Baky MD, Hussam M. Abdul Azeem MD
and Abu Bakr Ras MD
Department of otorhinolaryngology. Benha Faculty of Medicine. Egypt
Abstract
With the progress of functional endoscopic sinus surgery (FESS). more interest had been paid to middle turbinate (MT) as it forms a key land¬mark of lateral nasal wall. It affects visualization during surgery, the out¬come and follow up after surgery.
Many surgeons prefer to totally resect MT other recommend leaving it untouched. The present study partial resection of the MT was carried out and the outcome was evaluated. The study included 20 patients witfi chronic sinusitis planned to undergo FESS. They were prepared for the operation, full history. ENT and endoscopic examination. CT scan, labora¬tory investigation and follow up for 6 months postoperatively. FESS was conducted according to the extent of the disease. One sixth ofMT was re¬sected (including and lower 1/2 of anterior end and the anterior 1/3 of the lower border).
The procedure was conducted safely with minimal bleeding and no other complications. Resection allowed better visualization during and af¬ter surgery.
Resection was done unilaterally in 9 cases (45%) and bilaterally in (55%) of cases depending on the present of concha bullosa, hypertrophied turbinate, paradoxically bent MT. or if it obstructs the view during sur¬gery.
Follow up showed improvement in 80% of cases, postoperative synech-iae were restricted to 2 cases (10%) with no lateralization of MT as well as better stability of MT. So. partial resection of MT proved to be safe pro¬cedure, improve visualization during and after surgery. As it reduced the weight of MT it allowed better stability and less synechiae formation with
no lateralization o/MT. Meanwhile the rest ofMT was kept in place as an important landmark of lateral nasal wall and the complications of total middle twbinectomy were avoided.
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