What Is a Turbinectomy?

Hypertrophy of the middle turbinate (mucosa or bone) or polyp-like changes that affect breathing, smell, and sinus drainage.

Middle Turbinectomy

Hypertrophy of the middle turbinate (mucosa or bone) or polyp-like changes that affect breathing, smell, and sinus drainage.

Chinese name

Middle Turbinectomy

ICD encoding

21.6903

Classification

Sinus Surgery Hypertrophic Rhinitis Surgery

Adverse symptoms

Postoperative bleeding, meningitis

Middle turbinate resection is suitable for:

1. Middle turbinate hypertrophy and nasal septum contact cause reflex headache or middle turbinate hypertrophy and stimulate sphenopalatine nerve.

2. Middle turbinate hypertrophy obstructs the olfactory sulcus and affects olfactory and total nasal ventilation.

3. To ensure the smooth progress of intranasal surgery, such as ethmoid sinus opening, nasal frontal canal enlargement, and sphenoid sinus natural mouth enlargement.

4. Middle turbinate hypertrophy, affecting the maxillary sinus, frontal sinus and anterior ethmoid sinus drainage.

5. Hypertrophy of the back of the middle turbinate forms a polyp-like change that protrudes toward the posterior nostril.

1. When there is acute inflammation of nasal mucosa, pharynx and middle ear.

2. Hemorrhagic diseases such as thrombocytopenic purpura and severe anemia.

3. Systemic diseases such as diabetes, hypertension, poor cardiopulmonary function compensation, severe arteriosclerosis, and active tuberculosis.

4. During pregnancy or menstrual cramps.

1. On the day before surgery, check the nasal cavity for inflammation and secretions, and determine the area of the lower turbinate to be resected. At the same time, remove the nasal hair and clean the nasal cavity.

2. Take Diazepam (Diazepam) 5mg before surgery.

1% tetracaine adrenaline adrenaline mixture (6: 1) is placed on a thin cotton sheet, squeezed and placed on the back of the middle turbinate near the sphenopalatine ganglion, the surface of the middle turbinate, the middle nasal passage, and the middle turbinate The nasal septum mucosa was also anesthetized. The posture is semi-seated.

Can be divided into partial turbinate resection and total turbinate resection.

1. Partial turbinate resection

It can be divided into anterior and posterior polypectomy.

(1) Removal of the middle turbinate front end: Use the middle turbinate scissors to cut the required resection from the root of the middle turbinate. At the same time, press down to make the incision wide. Push the 0.3% wire trap to the incision to cover the middle turbinate. , Adjust the site to be removed and cut off.

(2) Polyp-like change in the back of the middle turbinate: Those who fall into the posterior nostril must anaesthetize the nasopharynx and oropharyngeal mucosa in addition to nasal anesthesia. Hold the nasal trap in the right side and send it to the nasopharynx from the nasal cavity and the bottom of the nasal cavity in parallel. The left hand indicates that the nasal polyp is inserted into the nasal trap through the mouth, tighten the nasal polyp to the root, and cut the nose while pulling. polyp.

2. Total turbinate resection

Cut the middle turbinate bone with the middle turbinate scissors at the front 1/3 of the middle turbinate, and press down with scissors to make the incision larger. Use a nasal snare, with the direction parallel to the nasal septum. Insert the middle turbinate with the back end from the inner lower edge of the middle turbinate, then push the nasal snare up to the front 1/3 of the cut middle turbinate, slowly tighten and shrink Trap, lower the middle turbinate. Remove the middle turbinate with gun-shaped forceps and check whether the base of the middle turbinate is smooth. If there are bone fragments, the edges of the mucosa are not uniform. Use a nasal polyp bite forceps to trim it so that the bone margin is embedded in the mucosal margin to facilitate healing. If there is not much bleeding during the operation, a gelatin sponge can be used to stick to the wound. If there is bleeding, use Vaseline gauze to compress.

1. When cutting the front 1/3 of the middle turbinate, the direction of the scissors should be downward, and it should not be tilted up, so as not to damage the sieve plate with the tip of the scissors.

2. When the middle turbinate is completely removed, keep a small amount of attachment at the back end. Do not remove too much to avoid bleeding.

3. The middle turbinate bone is thick and hard. When the nasal snare can not be set down, you can use the ethmoid sinus bite forceps to bite off, but you can't break or tear it hard to avoid damage to the ethmoid bone level plate.

1. The patient takes a semi-sitting position and applies ice to the nose.

2. Packing gauze strips are generally taken out at 24h after surgery. After that, the nasal cavity was changed once a day to check for bleeding and crusting, and cleaned up to prevent granulation growth and nasal adhesions.

3. Antibiotic and ephedrine mixture is dripped into the nasal cavity after pulling out the gauze to prevent infection and adhesion.

1. Hemorrhage, such as excessive removal of the rear end of the middle turbinate, can cause major bleeding from injury to the lateral branch of the sphenopalatine artery.

2. Meningitis is a relatively rare complication, which damages the ethmoid plate and fills the nasal cavity. Headache, nausea, vomiting, and neck stiffness may occur within a short period of time after surgery.