Medialization and Stabilization of the Middle Turbinate using a Nasal Septal Flap in Endoscopic Sinus Surgery

LATERAL synechiae formation of the middle turbinate remains the most common complication in endoscopic sinus surgery. It results in recurrence of sinus symptoms due to blockage of the ostio-meatal complex and patient dissatisfaction. Some surgeons opt to partially resect the middle turbinate to ensure post-operative patency of sinus drainage but we consider this technique quite radical and contradictory to the conservative principle of functional endoscopic sinus surgery. In untrained hands, a planned partial resection may lead to total resection and loss of anatomic landmarks essential in revision surgery. Excessive middle turbinate manipulation may compromise such nasal functions as filtration, humidification and laminar flow. We propose a simple technique to preserve, medialize and stabilize the middle turbinate through a planned medial synechiae formation using a nasal septal flap.