Turbinectomy Periprocedural Care

Updated: Mar 01, 2016
  • Author: Philip E Zapanta, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Periprocedural Care

Equipment

See the list below:

  • Audiovisual tower
  • Endoscopic camera head
  • 0° rigid nasal endoscope
  • Endoscopic sheath: This helps guard the scope from any accidental trauma and helps give the rigid scope some weight. This added weight tends to help manual dexterity and provide instrument feedback during the case.
  • #8 Frazier tip suction
  • #15 blade
  • Takahashi forceps
  • Long Metzenbaum scissors
  • Suction cautery for troublesome bleeding
  • Boise elevator
  • Freer
  • Suction Freer
  • Microdebrider and handpiece (Medtronic Xomed StraightShot M4 Microdebrider, Integrated Power Console)
  • Tricut Blade 3.5 mm microdebrider blade (Medtronic)
  • 2.0 mm Inferior Turbinate Blade (Medtronic)
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Patient Preparation

Anesthesia

Under most circumstances, the author performs the following turbinate reduction procedures using general anesthesia.

Using a headlight and a nasal speculum, examine the nasal airway taking note of the size of the inferior turbinates. Place 2 oxymetazoline pledgets (1/2 in by 3 in) in both nasal cavities (4 pledgets needed).

Positioning

The room is set up like a sinus endoscopy case. Because the author is a right-handed surgeon, he has the AV tower and monitor across from him on the patient’s left-hand side, and he will stand on the patient’s right. The patient is supine, and the anesthesiologist tapes the endotracheal tube to the left. The author tucks the patient’s right arm only, and the anesthesiologist will have access to the left arm. The author prefers that the anesthesiologist place the blood pressure on the patient’s left arm so the cuff doesn’t repeatedly inflate in the author’s way during the case. The patient is prepped and draped in the standard fashion for endoscopic sinus surgery.

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Complications

Complications may include the following:

  • Postoperative epistaxis
  • Pain
  • Recurrence
  • Crusting
  • Foul odor
  • Synechia
  • Epiphora from nasolacrimal duct injury
  • Atrophic rhinitis or empty nose syndrome: This is typically seen in total or radical turbinectomy.
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