Turbinate

Endoscopic view of a maxillary antrostomy through the inferior turbinate

October 31, 2010     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
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Inferior turbinate osteoma: Case report

April 30, 2010     Borlingegowda Viswanatha, MS, DLO
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Abstract

Osteomas of the turbinates are extremely rare. In this report, a case of inferior turbinate osteoma in a 24-year-old woman is described. The patient presented with a 6-month history of unilateral nasal obstruction. Computed tomography showed a bony dense mass in the anterior part of the left inferior turbinate. The lesion was removed endoscopically, and the patient recovered uneventfully. To the best of the author's knowledge, this is only the fifth case of a turbinate osteoma to be reported in the world literature, and only the second case that involved the inferior turbinate.

Endoscopic view of ossification of the middle turbinate and ethmoid sinus

March 31, 2010     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
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Endoscopic view of the basal lamella of the middle turbinate

March 1, 2010     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
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Endoscopic view of a trans-middle turbinate ethmoidectomy

May 31, 2009     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
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Bilateral transversely clefted middle turbinates

March 31, 2009     Laura M. Dooley, MD and C.W. David Chang, MD
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Isolated extramedullary plasmacytoma of the middle turbinate

February 1, 2009     Tengku A. Shahrizal, MS, Narayanan Prepageran, FRCS, Omar Rahmat, MS, Kein-Seong Mun, MPath, and Lai-Meng Looi, FRCPath
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Abstract

Extramedullary plasmacytoma is a rare plasma cell proliferative disorder with a predilection for the head and neck region. Occasionally, it presents as a solitary lesion in the nasal cavity. We report a case of an isolated lesion in the middle turbinate of the right nasal cavity. The lesion was completely excised via an endoscopic approach. We also review the pathology and management of plasmacytomas in general.

Suture medialization of the middle turbinates during endoscopic sinus surgery

December 1, 2008     Kim M. Hewitt, MD and Richard R. Orlandi, MD
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Abstract

Adhesion of the middle turbinate to the lateral nasal wall is a common complication of endoscopic sinus surgery. The potential sequela of middle turbinate lateralization is obstruction of the middle meatus and the maxillary, ethmoid, or frontal sinuses, which can result in recurrent sinus disease and often necessitate revision surgery. While various materials and stents have been developed to prevent middle turbinate adhesion to the lateral nasal wall, suture medialization of the middle turbinate to the nasal septum with an absorbable suture has the potential to be just as successful without causing the discomfort associated with other methods. We conducted a retrospective review of suture medializations of 157 middle turbinates in 85 patients who had undergone endoscopic sinus surgery to ascertain the incidence of postoperative middle turbinate adhesion to the lateral nasal wall. We found that adhesions developed in 17 middle turbinates (10.8%) in 15 patients; the remaining 140 middle turbinates (89.2%) were free of scarring. Thirteen of the 17 adhesions were easily divided in the outpatient clinic setting during routine postoperative endoscopic care, meaning that only 4 of the 157 turbinates (2.5%) demonstrated synechiae that remained problematic after routine care. We conclude that the development of clinically significant adhesions following suture medialization of the middle turbinate is uncommon. Suture medialization should be considered as an alternative to middle meatal packing or stenting to prevent adhesions following endoscopic sinus surgery.

Superior turbinate pneumatization in patients with chronic rhinosinusitis: Prevalence on paranasal sinus CT

September 25, 2008     Seth J. Kanowitz, MD, Annette O. Nusbaum, MD, Joseph B. Jacobs, MD, and Richard A. Lebowitz, MD
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Abstract

With the availability of high-resolution computed tomography (CT), a great deal of attention has been paid to the anatomy of the paranasal sinuses. But while investigators have focused on the osteomeatal complex and its relation to chronic rhinosinusitis, there has been little discussion of the superior turbinate. Although a few anatomic studies have tried to quantify pneumatization of the superior turbinate, the prevalence of this finding on radiography is not well addressed in the literature. We prospectively studied 100 consecutively presenting patients who underwent coronal CT of the paranasal sinuses (200 sides) for the evaluation of symptoms of chronic rhinosinusitis at an academic tertiary referral center to determine the prevalence of pneumatization of the superior turbinate. We found evidence of pneumatization in 44 of the 200 sides, for a prevalence of 22%. In all, pneumatized superior turbinates were found in 27 patients (27%)—bilaterally in 17 (17%) and unilaterally in 10 (10%).

Office CO2 laser turbinoplasty

June 30, 2008     Gordon J. Siegel, MD, Kristin A. Seiberling, MD, Kenneth G. Haines, MD, Kenneth G. Haines, MD, and Allison S. Aguado, MD
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Abstract

We conducted a prospective study of office carbon dioxide (CO2) laser turbinoplasty as a treatment for symptoms related to turbinate dysfunction in 58 patients. All patients completed surveys before and 1 month after treatment, and 23 patients completed longer-term follow-up surveys 8 to 24 months postoperatively. The 1-month postoperative assessments demonstrated a trend toward symptom improvement, as many patients reported a decrease in their use of pretreatment medications. Long-term benefit was achieved in 70% of patients. Ten patients underwent pre- and post-treatment biopsies, and histologic evaluation demonstrated minimal tissue alteration following treatment, alleviating concerns of physiological and functional compromise. We conclude that office-based CO2 laser turbinoplasty is a useful tool for the treatment of disorders related to turbinate dysfunction. We describe one clinician's method of performing office CO2 laser turbinoplasty, and we report his experience and findings.

Cavernous hemangioma of the middle turbinate: A case report

June 30, 2008     Fatma Çaylakli, MD, Alper Can Çağici, MD, Cem Hürcan, MD, Nebil Bal, MD, Osman Kizilkiliç, MD, and Fikret Kiroglu, MD
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Abstract

Most cavernous hemangiomas present at birth or soon after. Cavernous hemangiomas of the nasal cavity, which are rare, usually do not present until adulthood; their incidence peaks in the fourth decade of life. Most affected patients experience epistaxis or hemoptysis and an enlarging lesion in the nose. Histologically, cavernous hemangiomas appear as closely packed, dilated vascular channels lined with a layer of flattened endothelial cells. We describe the case of a 32-year-old man who was admitted to our clinic with the complaint of a nasal obstruction. On anterior rhinoscopy, he was found to have a hypervascularized and hypertrophied left middle turbinate and septal deviation. Computed tomography and magnetic resonance imaging of the paranasal sinuses demonstrated a well-defined cystic lesion that had arisen within the bony left middle turbinate and caused deviation of the septum to the right. The lesion was excised via endoscopic surgery with general anesthesia. No complications occurred during the postoperative period. Histologic examination identified the tumor as a cavernous hemangioma. To the best of our knowledge, this is the first case reported in the English-language literature of a cavernous hemangioma appearing as a cystic mass in the middle turbinate.

Endoscopic view of a septated concha bullosa

February 1, 2008     Eiji Yanagisawa, MD, FACS, Joseph P. Mirante, MD, FACS, and Dewey A. Christmas, MD
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