Submucosal turbinate resection with septoplasty
PREOPERATIVE DIAGNOSIS: Deviated septum with inferior turbinate hypertrophy.
POSTOPERATIVE DIAGNOSIS: Deviated septum with inferior turbinate hypertrophy.
PROCEDURE: Septoplasty, bilateral inferior turbinate submucosal resection.
FINDINGS: The patient had a buckled, deviated septum with bilateral inferior turbinate hypertrophy.
PROCEDURE IN DETAIL: The patient was taken to the operating room under general anesthesia where orotracheal intubation was performed. The nose was injected with 8 cc of 0.5% lidocaine plus 1:200,000 epinephrine. The face was prepped and draped in the usual fashion. A left-sided Killian incision was made. The bilateral mucosal flaps were elevated and the quadrangular cartilage was noted to be deviated and overriding. The cartilage was resected with a generous dorsal and caudal strut. The posterior bone was taken down with double-action forceps and the maxillary crest was isolated and taken down with a chisel. The septum was closed anteriorly with chromic and more posteriorly with a whip stitch. After local injection, bilateral anterior stab incisions were made and bilateral mucosal inferior turbinate tunnels were created. The turbinate microdebrider was then used to submucosally resect tissue and the right flap was kept intact but a tear was created in the left flap. The turbinates were then outfractured and the patient was awakened, extubated, and transported to the recovery room in good condition.