Nasal Obstruction

Question 1

What are the surgical options for nasal obstruction?

Answer 1

1. Address the area of obstruction
2. Any components of the nasal valve - septum, turbinate, alar cartilage support
3. Septoplasty
4. Spreader, batten or overlay grafts
5. Lateral crural or columellar strut grafts
6. Nasal-orbital suspension
7. Inferior turbinate reduction
8. Flaring sutures
9. Valvuloplasty with composite graft

Question 2

What are 6 methods for inferior turbinate reduction?

Answer 2

1. Out-fracture lateralization
2. Submucosal soft tissue reduction (electrocatuery, radiofrequency coblation, microdebrider)
3. Resection of inferior turbinate bone
4. Resection of inferior turbinate bone and lateral mucosa
5. Partial mucosa soft tissue resection or ablation (ie. laser turbinectomy)
6. Total turbinectomy

Vancouver 418 images

Question 3

Discuss middle turbinate removal

Answer 3

• No QOL or functional changes with resection
• Patients with inflammatory sinus disease actually smell better
• Likely from better topical delivery, no middle meatus obstruction, and better inflammation control