Accidental middle turbinectomy by nasotracheal intubation: A case report

Nasotracheal intubation is an anesthetic technique widely used for maxillofacial surgery. It has the advantage of easier access to the surgical site to surgeon. However, when the nasothracheal intubation is performed a few complications may occur, such as nasal mucosa damage, epistaxis, sinusitis by sinus drainage occlusion and transient bacteremia. In addition, concha bullosa is a common anatomic variant of the middle turbinate, which is pneumatized, and very susceptible to trauma. We report a case of accidental middle turbinectomy by nasotracheal intubation, in the patient who had bilateral concha bullosa.

Middle Turbinectomy During Dacryocystorhinostomy

Successful lacrimal surgery requires the greatest familiarity with anterior and superior portion of the intranasal cavity. Some racial differences exist between Asians and Caucasians in nasal surgical anatomy. Eighty four subjects of eighty two patients who received dacryocytorhinostomy between February 1991 and October 1995 were studied retrospectively. Of the 84 subjects, the middle turbinectomy was required in 65 cases(77.4%). An anatomical success rate of 94.7% and functional success rate of 83.3% were obtained over a 7.9 month follow-up period. Frequency of turbinate surgery was relatively high because large, anteriorly located middle turbinate is more frequent in Asians than Caucasians. In many cases, knowledge of intranasal surgical anatomy and intranasal procedures are required for successful lacrimal surgery.