3 types of wands available for turbinate coblation surgery as shown above.
Figure shows the postoperative appearance of healed left inferior turbinate
after partial turbinectomy performed. The tail of inferior turbinate (white arrow)
was left untouched. Some degree of mucosal hyperplasia can still recur.
[S- nasal septum, stars mucosal cover of turbinate remnant,
red arrow- nasolacrimal duct opening (covered by mucosa- valve of Hassner].
Thin mucosal cover of inferior concha after right subtotal inferior turbinectomy.
Inferior tubinate tail preservation in partial turbinectomy as this part
can potentially bleed as the vessel feeders are in proximity distally.
[ITT- inferior turbinate tail, MT- middle turbinate, N- nasopharynx]
Significantly hypertrophied inferior turbinate (+) and concha in a patient with allergic rhinitis who present with refractory nasal obstruction despite good compliance to intranasal corticosteroid therapy.
X-ray of a patient who had bilateral inferior turbinectomy showing widely patent nasal cavity - compare with the figure above.
Endoscopic appearance of left middle turbinate concha bullosa (CB). (S - septum)
Endoscopic view of left middle turbinate concha bullosa showing its pneumatized cavity. Its lateral-halve will be excised leaving its cavity wide open and epithelialized naturally while preserving the medial attached side as natural landmark. (S - septum)
Figures showing an introperative endoscopic view of left concha bullosa after it was uncapped. The mucosa appeared hyperplastic and this will revert
to normal upon healing.
Watch video of concha bullosa surgery @ YouTube
PC - posterior choana, V - vomer, MT - middle turbinate, F - flap raised, A - maxillary antrum, arrow - sphenopalatine artery.
F - flap raised, A - maxillary antrum, arrow - sphenopalatine artery,
The artery can be ligated using Liga clip or cauterized using bipolar diathermy device as shown below.