Powered inferior turbinoplasty in children

M S Rubasinghe

doi:10.4038/cjo.v10i1.5315

Abstract

Powered inferior turbinoplasty in children is described in detail in this “How I do it” article. This procedure is not commonly done in either children or in adults in the local setup. The procedure is simple, rarely gives complications and relatively easy. Equipment and instruments needed for this procedure are available in most of our ENT theatres.

Highlights

Inferior turbinate hypertrophy in children can be troublesome causing nasal obstruction andsnoring,sometimes leading to poor sleep a poor quality of life.When medical management fails, which is usually a trial of a steroid nasal drops or aerosol spray for at least 3 months, a surgical procedure is recommended for symptomatic relief [1].Commonly done procedures in children with this regard are inferior turbinate reduction using needle monopolar submucosal diathermy or bipolar surface diathermy of the anterior half of the inferior turbinate
Patties are placed under direct visualization usinga zero degree rigid nasal endoscope and with a help of a Tilleys nasal dressing forceps and a Freer ’selevator. (Figure 1)Patties are strategically placed in the inferior meatus, over the turbinate and in between the septum and the medial surface of the inferior turbinate.Altogether 6 patties are used on both sided of the nasal cavities and left for 1 minute.Once the packs are taken out by pulling their attached strings,the turbinates would appear much more decongested
With the debrider in the oscillationmode, soft tissue is gradually removed from anterior to posterior direction until the turbinate bone is exposed (Figure 2).Once the bone is exposeda FESSball probe is used to separate the bone from underlying mucosa (Figure 3)

Summary

Introduction

Inferior turbinate hypertrophy in children can be troublesome causing nasal obstruction andsnoring,sometimes leading to poor sleep a poor quality of life.When medical management fails, which is usually a trial of a steroid nasal drops or aerosol spray for at least 3 months, a surgical procedure is recommended for symptomatic relief [1].Commonly done procedures in children with this regard are inferior turbinate reduction using needle monopolar submucosal diathermy or bipolar surface diathermy of the anterior half of the inferior turbinate. Inferior turbinate powered reduction is not commonly done in children and this article depict how the surgeon performs the procedure. Under general anaesthesia both inferior turbinates are in-fractured.Nasal cavities are packed with patties soaked in Moffett’s solution.(1ml of 1:1000 Adrenaline, 1ml 10%Cocaine and 6ml 0. Once the bone pieces are completely freed, they are piecemeal removed with a 45 degree upturned or straight Blackesely forceps [2]. This has to be continued anteriorly and posteriorly.

Discussion

Conclusion