Surgical anatomy of the posterior ends of the middle and inferior turbinates

Abstract

Background : Preservation of structure and reestablishment of function is the guiding principle during an endoscopic intervention. Especially, when a partial middle turbinectomy is unavoidable, middle turbinate can lose its stability. Variations of middle turbinate like severe anterior bulging, posterior protrusion beyond the inferior turbinate and the larger size than inferior turbinate have significant impact on its stability. Aim: To study surgical anatomy of the middle and inferior turbinates. Method: The distances and angles between the limen nasi and posterior ends of the middle and inferior turbinates were studied in 100 hemisected adult Indian cadaveric heads. Results: The mean angles between the line passing through the lowermost portion of limen nasi and posterior ends of middle turbinate and inferior turbinate respectively are bl was 19.87° and b2 was 10.57°. The mean distance between the lowermost portion of limen nasi and posterior ends of middle turbinate and of inferior turbinate were xl is 55.88 + 3.61 mm andx2 was 52.69 + 3.57 mm.The mean distances between the lowermost portion of limen nasi and the perpendicular from the posterior ends of middle turbinate and inferior turbinate to the hard palate were7/= 52.47 + 3.33 mm (range: 44.16 to 59.92 mm) and y2= 51.75 ± 3.45 mm (range 43.32 to 61.22 mm) respectively. In 52% cases middle turbinate extends more posterior with respect to inferior turbinate i.e.M > I and in 48% cases inferior turbinate extends more posterior with respect to middle turbinate of M < I. Conclusion : The documentation of these parameters and the related variations is likely to be useful for the endoscopic surgeons.