The Surgical Management of The Inferior Turbinates

The Surgical Management of The Inferior Turbinates

Steven M. Houser


The inferior turbinates are structures with a bony frame work enveloped in both submucosa and mucosa that play a vital role in nasal physiology. The submucosal layer contains the lamina propria, which includes key histologic elements, such as parasympathetic nerve fibers, mucous glands, goblet cells, and abundant vasculature. The vasculature includes special vessels that can become engorged by pooling blood and enlarge the entire structure. The mucosal cover of the inferior turbinates consists of ciliated pseudostratified columnar epithelium, which allows for capturing larger inhaled particles (>4 µm) that can be trapped in mucus, thereby sparing the lungs from a potential insult. The inferior turbinates provide a broad surface area to allow moisture exchange during the inhalation and exhalation of air. The turbinates also appear to play a role in the sensation of nasal airflow through the nose. Despite the importance of inferior turbinates, there are times when these structures are problematic. When the inferior turbinates become too large, either intermittently or permanently, they may obstruct the nasal airway and negatively impact quality of life.

Many methods for turbinate reduction have been described; these include thermal or chemical coagulation, lateralization, submucosal reduction, submucous bone resection, and partial or total turbinate excision. Total inferior turbinectomy was advocated in the late 19th century but was abandoned due to sequelae only to resurge again in the 1970s when previous complications were doubted. As is common in surgery, a judicious and tailored approach typically provides optimal outcomes.

Jun 15, 2016 | Posted by in OTOLARYNGOLOGY | Comments Off on The Surgical Management of The Inferior Turbinates

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