Middle turbinate handling during ESS. Our experience.

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Innovation

Background:

• Management of the middle turbinate (MT) during endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) is a subject of ongoing debate.
• While MT preservation is often recommended to mitigate complications, resection is sometimes unavoidable.

Purpose of the Study:

• To describe an original surgical technique for MT preservation and stabilization during ESS.
• To evaluate the preliminary outcomes of this technique regarding post-operative endoscopic findings and complication rates.

Main Methods:

• A retrospective analysis of 34 adult patients with CRS undergoing primary or revision ESS.
• The technique involved creating a surgically induced adhesion between the MT head and nasal septum and placing a silicone plate in the ostiomeatal complex (OMC) to stabilize the MT.

Main Results:

• Successful MT medialization and stabilization were achieved in all patients at 12-month follow-up.
• Only one instance of lateral synechia occurred, without recurrent CRS.
• The rate of polypoid recurrence was 13%.

Conclusions:

• The described MT handling technique appears effective for medializing and stabilizing the MT during ESS.
• This approach may be particularly beneficial for managing unstable MTs following the removal of extensive inflammatory mucosal lesions.