Submucous resection turbinate with septoplasty and endoscopic concha bullosa resection

PREOPERATIVE DIAGNOSES:
Deviated septum.
Turbinate hypertrophy.

POSTOPERATIVE DIAGNOSES:
Deviated septum.
Turbinate hypertrophy.

PROCEDURE PERFORMED: Septoplasty. Bilateral inferior turbinate submucous resection. Endoscopic resection of right concha bullosa.

FINDINGS: The patient had a large right-sided concha bullosa and a severely deviated septum to the left. She also had inferior turbinate hypertrophy.

PROCEDURE IN DETAIL: The patient was taken to the operating room, where general anesthesia with orotracheal intubation was performed. The nose was packed with Afrin and locally injected with lidocaine plus epinephrine. The face was prepped and draped in the usual fashion and a left-sided Killian incision was sharply incised. Bilateral mucosal flaps were elevated and the inferior half of the quadrangular cartilage was resected. The remaining deviated bone was taken down posteriorly and the maxillary crest was isolated in the midline and taken down with a chisel. A small tear on the left flap was created but the right side was kept intact. The septum was then closed anteriorly with chromic and posteriorly with whipstitch.

Following this, endoscopic injection of the right middle turbinate was performed and the middle turbinate was sharply incised using a 0-degree endoscope and the medial half of the turbinate was resected with through-cutting forceps. The exposed bone was then trimmed up carefully and both inferior turbinates were locally injected. Bilateral anterior stab incisions were made and submucosal tunnels were created with the freer. Using the turbinate microdebrider submucosal tissue of both inferior turbinates was resected. The patient was awakened, extubated and transported to the recovery room in good condition.

codes: 
Code: 
30140
Code Type: 
CPT
Code: 
30520
Code Type: 
CPT
Code: 
31240
Code Type: 
CPT
Code: 
21.88
Code Type: 
ICD-9
Code: 
22.19
Code Type: 
ICD-9
Code: 
21.69
Code Type: 
ICD-9
Code: 
09QM0ZZ
Code Type: 
ICD-10
Code: 
09BL8ZZ
Code Type: 
ICD-10