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Nasal surgery is a specialty including the removal of nasal obstruction that cannot be achieved by medication and nasal reconstruction. Currently, it comprises four approaches, namely rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, targeted at different sections of the nasal cavity in the order of their external to internal positions.
A turbinectomy or turbinoplasty (preserving the mucosal layer) is a surgical procedure, that removes tissue, and sometimes bone, of the turbinates in the nasal passage, particularly the inferior nasal concha. The procedure is usually performed to relieve nasal obstructions. [1]
Empty nose syndrome (ENS) is a clinical syndrome, the hallmark symptom of which is a sensation of suffocation despite a clear airway. This syndrome is often referred to as a form of secondary atrophic rhinitis. ENS is a potential complication of nasal turbinate surgery or injury.
Occasionally, a large concha bullosa may cause it to bulge sufficiently to obstruct the opening of an adjacent sinus, possibly leading to sleeping apnea or breathing disorder related to areas innervated by the trigeminal nerve. [2] In such a case the turbinate can be reduced in size by endoscopic nasal surgery (turbinectomy).
In the case of turbinate reduction, only small amounts of turbinate tissue are removed because the turbinates are essential for respiration. Turbinectomy is usually reserved for patients who have persistent symptoms despite previous turbinate reduction surgery. Risks of reduction of the inferior or middle turbinates include empty nose syndrome. [8]
•Thudichum's nasal speculum-do-; short blades ( uses: anterior rhinoscopy - to see the Little's area, ant-inferior part of nasal septum, anterior part of inferior and middle turbinate and meatus, as well as any pathological lesion in the area; also used in certain nasal operations ) •St. Clair Thompson's long bladed nasal speculum
Atrophic rhinitis can also result from long-standing purulent sinusitis or radiotherapy of the nose, or as a complication of surgery of the turbinates. [4] The United Kingdom National Health Service has stated that "Most cases of atrophic rhinitis in the UK occur when the turbinates are damaged or removed during surgery". [5]
The inferior nasal concha (inferior turbinated bone or inferior turbinal/turbinate) is one of the three paired nasal conchae in the nose. It extends horizontally along the lateral wall of the nasal cavity and consists of a lamina of spongy bone , curled upon itself like a scroll, ( turbinate meaning inverted cone). [ 1 ]