Basic Info: A 14-year-old male presented with chronic nasal obstruction and awake stertor. It was discovered that the patient had severe bilateral turbinate hypertrophy. A trial of Flonase and antihistamine was attempted with no improvement. It was recommended that the patient undergo a bilateral nasal turbinate reduction. This procedure is displayed step-wise in the video.
Introduction: Chronic nasal obstruction can be caused by inferior turbinate hypertrophy. This video portrays a surgical treatment for turbinate hypertrophy, a turbinate trim with a microdebrider blade.
Methods: An Afrin pledget was inserted into each nostril and lidocaine was injected into each inferior turbinate. Each turbinate was medially fractured using a freer. The microdebrider blade was used to trim the inferior 1/3 of each turbinate. A freer was used to out-fracture each inferior turbinate. Afrin pledgets were inserted into each nostril for hemostasis.
Results: The inferior one-third of each inferior turbinate was removed via a microdebrider. Patient was sent to recovery in good condition, and Afrin pledgets were removed in recovery once hemostasis was achieved. No adverse reactions were reported by the surgeon or patient.
Conclusion: Chronic nasal obstruction can be significantly improved by an inferior turbinate trim and out-fracture.
Author: Merit Turner, BS, BS
Surgeon: Gresham T. Richter, MD
Institutions:
Department of Otolaryngology-Head and Neck Surgery, Arkansas Children’s Hospital, Little Rock, AR
University of Arkansas for Medical Sciences, Little Rock, AR