gms | German Medical Science

Objectives: Functional endoscopic sinus surgery (FESS) is one of the most common operations done by Otolaryngologists nowadays. One postoperative complication is the lateralization of the middel turbinate which often leads to an obstruction of the infundibulum. The purpose of this study was to find out whether this complication can be predicted intraoperatively.

Methods: 45 patients (25 male, 20 female) were included into this prospective study. All underwent a FESS for the first time on both sides. Intraoperatively, the surgeron had to give a statement about the size and the stability of the middle turbinate. Furthermore the distance between the middle turbinate and the lateral nasal wall was assessed. According to this data the risk was analysed whether the middle concha whould lateralize.

Results: 13 (14%) of 90 middle conchae lateralize within 4 weeks after the operation. In 10 of these cases the surgeon judged the middle turbinate to be mobile or large (sensitivity: 77%; positive specifity 80%). In 15 other cases were the middle turbinate was considered to be mobile or large a lateralization could not be observed.

Conclusions: It could be demonstrated that an intraoperative mobile or large middle turbinate often leads to a lateralization of the middle turbinate. According to this results the otolaryngologist should take measure if the conchae is mobile, large or the distance to the lateral nasal wall small intraoperatively.