Post Op: Nasal obstruction, nasal septal deviation, turbinate hypertrophy, chronic rhinosinusitis, and nasal polyposis.
Procedure: Septoplasty, bilateral submucous resecton of turbinates, bilateral sphenoidotomy with removal of tissue, right anterior ethmoidectomy.
Description:
Afrin-soaked pledgets were placed into the nares bilaterally for topical vasconstriction and 1% lidocaine with epinephrine was injected into the septum in the region of the deviation. At this time, a Cottle elevator was used to raise an inferior flap submucosally overlying an inferior left septal bone spur. A chisel was used to remove the obstructing inferior bone along the floor of the nasal cavity, which was done from an anterior to posterior manner. Once this was removed, it was seen that the area has significantly improved. The flap was then replaced. The patient had minimal EBL in this region.
At this time, attention then was turned to the right side of the nasal cavity. Using a combination of the straight-0 degree microdebrider blade and the pediatric forceps, the natural ostium of the sphenoid sinus was identified. It was opened to gain access to the anterior sphenoid sinus. This was noted to be approximately 7 cm formt he anterior nasal vestibule. The anterior sphenoid sunus antrostomy was enlarged. Using the Xomed microdebrider blade, polypoid soft tissue was removed from the floor of the sphenoid sinus inferiorly and anteriorly. After the sphenoidotomy was performed, attention was turned the next area of surgery. Findings were polypoid tissue present at the spenoid os.
The anterior ethmoid bulla was identified and taken down in the usual fashion using a combination of the 0-degree microdebrider blade as well as the straight and pediatric 45-degree and 90 degree forceps. This was done in its entirety. At this time, the posterior ethmoid was identified and left in place. Care was taken to avoid all pertinent landmarks including the fovea ethmoidalis, cribriform plate, and lamina papyracea. At this time, after the anterior ethmoid air cells were completely removed, attention was turned to the sphenoid sinus.
Attention was then turned to the left side. Using a combination of the straight 0-degree microdebrider blade and the pediatric forceps, the natural ostrium of the sphenoid sinus was identified. It was opened to gain access to the anterior sphenoid sinus. This was noted to be approximately 7 cm from the anterior nasal vestibule. The anterior sphenoid sinus antrostomy was enlarged. Using the Xomed microdebrider blade, polypoid soft tissue was removed from the floor of the sphenoid sinus inferiorly and anteriorly. After the sphenoidotomy was performed, attention was turned to the next area of surgery. Findings were left polypoid tissue at the sphenoid os.
Does this documention support a Submucous resection of turbinates? If so can you please explain?! Thank you soo much
Procedure: Septoplasty, bilateral submucous resecton of turbinates, bilateral sphenoidotomy with removal of tissue, right anterior ethmoidectomy.
Description:
Afrin-soaked pledgets were placed into the nares bilaterally for topical vasconstriction and 1% lidocaine with epinephrine was injected into the septum in the region of the deviation. At this time, a Cottle elevator was used to raise an inferior flap submucosally overlying an inferior left septal bone spur. A chisel was used to remove the obstructing inferior bone along the floor of the nasal cavity, which was done from an anterior to posterior manner. Once this was removed, it was seen that the area has significantly improved. The flap was then replaced. The patient had minimal EBL in this region.
At this time, attention then was turned to the right side of the nasal cavity. Using a combination of the straight-0 degree microdebrider blade and the pediatric forceps, the natural ostium of the sphenoid sinus was identified. It was opened to gain access to the anterior sphenoid sinus. This was noted to be approximately 7 cm formt he anterior nasal vestibule. The anterior sphenoid sunus antrostomy was enlarged. Using the Xomed microdebrider blade, polypoid soft tissue was removed from the floor of the sphenoid sinus inferiorly and anteriorly. After the sphenoidotomy was performed, attention was turned the next area of surgery. Findings were polypoid tissue present at the spenoid os.
The anterior ethmoid bulla was identified and taken down in the usual fashion using a combination of the 0-degree microdebrider blade as well as the straight and pediatric 45-degree and 90 degree forceps. This was done in its entirety. At this time, the posterior ethmoid was identified and left in place. Care was taken to avoid all pertinent landmarks including the fovea ethmoidalis, cribriform plate, and lamina papyracea. At this time, after the anterior ethmoid air cells were completely removed, attention was turned to the sphenoid sinus.
Attention was then turned to the left side. Using a combination of the straight 0-degree microdebrider blade and the pediatric forceps, the natural ostrium of the sphenoid sinus was identified. It was opened to gain access to the anterior sphenoid sinus. This was noted to be approximately 7 cm from the anterior nasal vestibule. The anterior sphenoid sinus antrostomy was enlarged. Using the Xomed microdebrider blade, polypoid soft tissue was removed from the floor of the sphenoid sinus inferiorly and anteriorly. After the sphenoidotomy was performed, attention was turned to the next area of surgery. Findings were left polypoid tissue at the sphenoid os.
Does this documention support a Submucous resection of turbinates? If so can you please explain?! Thank you soo much
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