Endoscopic view of a concha bullosa of the middle turbinate.The term concha bullosa is used to describe the pneumatization of the middle turbinate turbinate /tur·bi·nate/ (-nat) 1. shaped like a top. 2. any of the nasal conchae. tur·bi·nate or tur·bi·nat·ed adj. 1. Shaped like a top. 2. . When the presence of a concha bullosa predisposes a patient to occlusion of the ostiomeatal complex and subsequent sinus disease, surgery might be indicated. There are several different methods of surgical management. In this article, we describe a method of resecting the lateral half of a symptomatic concha bullosa. In this case, a polypoid left concha bullosa was obstructing the ostiomeatal complex (figure, A). A vertical midline mid·line n. A medial line, especially the medial line or plane of the body. midline, n the line equidistant from bilateral features of the head. incision was made endoscopically in the anterior face of the concha bullosa with a #15 blade attached to a narrow Bard Parker knife handle (figure, B). (A sickle knife or adenoid adenoid /ad·e·noid/ (ad´e-noid) 1. pharyngeal tonsil. 2. pertaining to a pharyngeal tonsil. 3. resembling a gland. 4. (pl. punch can also be used.) The lateral half of the concha bullosa, including any diseased tissue contained within it, can be removed with an endoscopic scissors scissors Cutting instrument or tool consisting of a pair of opposed metal blades that meet and cut when the handles at their ends are brought together. Modern scissors are of two types: the more usual pivoted blades have a rivet or screw connection between the cutting ends , a through-cutting forceps, and/or a microdebrider. In this case, a portion of the anterior concha bullosa was removed (figure, B). In some cases, multiple polyps are found within the concha bullosa (figure, C); they should also be removed. Care should be taken not to destabilize the remaining medial turbinate lamella lamella /la·mel·la/ (lah-mel´ah) pl. lamel´lae [L.] 1. a thin leaf or plate, as of bone. 2. a medicated disk or wafer to be inserted under the eyelid. . It is also important to avoid excessive removal near the attachment of the vertical portion of the middle turbinate or the agger nasi because this might disrupt the attachment to the cribriform plate. Postoperatively, a packing should be placed between the turbinate and the lateral nasal wall to prevent adhesion or lateralization lat·er·al·i·za·tion n. Localization of function attributed to either the right or left side of the brain. of the middle turbinate. [1] The figure (D) shows a complete resection of the lateral half of the concha bullosa. Note that the medial half of the turbinate has been well preserved. The anterior edge is covered with preserved mucosa. From the Southern New England Ear, Nose, Throat, and Facial Plastic Surgery Group, New Haven, Conn.; the Section of Otolaryngology, Yale University School of Medicine, New Haven; and the Section of Otolaryngology, Hospital of St. Raphael, New Haven. Reference (1.) Yanagisawa E. Atlas of Rhinoscopy rhinoscopy /rhi·nos·co·py/ (ri-nos´kah-pe) examination of the nose with a speculum, either through the anterior nares (anterior r.) or the nasopharynx (posterior r.) . rhi·nos·co·py n. : Endoscopic Sinonasal Anatomy and Pathology. San Diego: Singular Publishing Group, 2000. |
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