Submucosal resection of the middle turbinate

The management of the middle turbinate during routine sinus surgery is controversial. A prominent middle turbinate can impair access to the middle meatus during and after surgery. While middle turbinate resection can improve this access, complications from this technique have been reported, including atrophic rhinitis, empty nose syndrome, anosmia, synechiae formation, turbinate lateralization, increased blood loss, and the loss of surgical landmarks in revision cases. The fate of the middle turbinate seems to be a reflection of each surgeon’s experience and preferences. Gentle medialization of the middle turbinate is often sufficient in providing access to the middle meatus and posterior sinuses. However, access with this technique may be limited when the middle turbinate contains hypertrophic bone. These cases may require some form of middle turbinate resection to allow access to the middle meatus. In an attempt to avoid the potential complications of full-thickness middle turbinate resection, we have utilized a submucosal resection technique to remove prominent bone while leaving the overlying mucosa intact.