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Concha bullosa: reducing middle meatal adhesions by preserving the lateral mucosa as a posterior pedicle flap

Published online by Cambridge University Press:  08 March 2006

Elizabeth A.W. Sigston
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Monash Medical Centre, Clayton, Victoria, Australia
Claire E. Iseli
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Monash Medical Centre, Clayton, Victoria, Australia
Tim A. Iseli
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Monash Medical Centre, Clayton, Victoria, Australia

Abstract

Background: Concha bullosa, an extensively pneumatized middle turbinate, may obstruct the paranasal sinuses. Messerklinger’s partial lateral turbinectomy is commonly used to debulk the concha bullosa, leaving a raw surface with the potential for adhesions.

Materials and methods: A modified technique of partial lateral turbinectomy is described. A posterior pedicled mucosal flap covers the inferior raw surface of the medial lamella of the middle turbinate. Three-month follow up of a consecutive series is compared with concurrent controls.

Results: Two (7 per cent) of 28 posterior pedicled flap and four (21 per cent) of 19 traditional partial lateral turbinectomies developed mild middle meatal adhesions (p = 0.011). Posterior pedicled flap reduced the need for post-operative cleaning of the middle meatus.

Conclusion: The posterior pedicled mucosal flap is a simple modification to partial lateral turbinectomy that covers the raw surface facing the lateral nasal wall, significantly reducing adhesions and speeding recovery.

Type
Brief Report
Copyright
© 2004 Royal Society of Medicine Press

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