Endoscopic view of a trans-middle turbinate ethmoidectomy

by Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS | Monday, June 01, 2009

An 82-year-old man presented with right facial discomfort medial and inferior to the right eye. He had been experiencing recurring bouts of ethmoid sinusitis over a 3-year period. Computed tomography (CT) showed an opacified right ethmoid sinus. Endoscopic examination revealed that the anterior portion of the middle turbinate had an unusual shape (figure, A). The patient elected to undergo right endoscopic ethmoidectomy under local anesthesia. He explained that he had experienced a difficult time during a previous right sinus operation 30 years earlier.Figure A: Telescopic view (4 mm, 0°) of the right nasal cavity shows the unusually shaped anterior portion of the middle turbinate. B: The concavity of the right anterior and middle portions of the middle turbinate is seen intraoperatively. C: The oval membranous area in the frontal plane of the middle turbinate is in direct contact with a deviated nasal septum. D: The membranous area is opened with a microdebrider. E: Polypoid .../continued/

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