Inferior turbinoplasty: patient selection, technique, and long-term consequences

When conservative medical management of symptomatically enlarged inferior turbinates is ineffective, the obstructing tissue may be reduced by an intramucosal or extramucosal destructive procedure (such as electrocautery, cryotherapy, or laser vaporization), or by conservative surgical resection. In the latter instance, enlarged conchal bones may be removed by the technique of turbinate submucous resection, while diffuse stromal hypertrophy necessitates partial resection of the inferior turbinates. A number of techniques of inferior turbinate surgery have been described. I have used the procedure of "inferior turbinoplasty" with increasing frequency for more than 9 years. Three to five years after such surgery, a detailed followup of 40 patients revealed none of the once-feared sequelae of turbinate resection, such as bleeding, crusting, foul nasal discharge, or bothersome postnasal drainage. Histologic examination of turbinates almost 5 years after turbinoplasty revealed fibrosis and scarring, with a marked decrease in mucous gland population, and normal mucosa. To obtain the best possible functional result inferior turbinate surgery is a necessary adjunct to most septal surgery. If conservatively done, it does not impair normal turbinate function. It must be stressed, however, that if the underlying cause of the turbinate hypertrophy is not addressed, recurrent obstruction can and probably will occur.