Endoscopic medialization middle turbinoplasty in endoscopic sinus surgery

Abstract

Recurrence of sinonasal disease can be caused by many factors, including lateralization of the middle turbinate as a complication of endoscopic sinus surgery (ESS). Different ESS procedures have been tried to prevent this complication. We conducted a prospective study to determine if medialization is an effective means of lateralizing the middle turbinate. Our study population was made up of 142 adults who underwent ESS from July 2013 through December 2014. A total of 235 sides were operated on; the middle turbinate was medialized in 90 patients (145 sides) and not medialized in 52 patients (90 sides). Follow-up ranged from 6 to 12 months. At 3 months postoperatively, the middle turbinate position was satisfactory on 210 sides (89%) and remained lateralized on the other 25 (11%). Among the latter, the turbinate obstructed the middle meatus in 16 patients and did not obstruct it in 9 patients. The 16 patients with obstruction required revision in the form of either a partial or complete turbinectomy, depending on the severity of the scarring. No complications were associated with middle turbinate medialization. We conclude that medialization middle turbinoplasty is an effective solution to a problem faced by many sinus surgeons. It is safe, quick, and easy to perform, and it is associated with minimal morbidity without adding to cost. It provides postoperative access to the ethmoid sinuses for debridement, and it reduces the risk of middle meatal stricture.