Document Detail

Basal lamella relaxing incision improves endoscopic middle meatal access.
MedLine Citation:
PMID:  23038164     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Lateralization of the middle turbinate is a commonly cited factor leading to failure of functional endoscopic sinus surgery (FESS). Inadequate medialization during FESS may require repeat intraoperative attempts, and may lead to destabilization and mucosal trauma. A novel technique is described that increases middle meatal area and provides more definitive medialization at the outset of FESS.
METHODS: Twenty-nine middle turbinate medializations were prospectively evaluated in 18 consecutive patients undergoing primary ESS. Three intraoperative images of the middle meatus were obtained in the native position, after Freer medialization, and after basal lamella relaxing incision (BLRI). Measurements of middle meatal area were then calculated in a blinded and randomized fashion.
RESULTS: Distances measured from the middle turbinate to the lateral nasal wall for each position ranged from 0 to 8 mm (median = 3.00 mm) for the native position, 0.5 to 10 mm (median = 5.00 mm) for standard Freer medialization, and 3 to 21 mm (median = 10.00 mm) for BLRI. Friedman's analysis of variance (ANOVA) showed that there was significant difference between the 3 measurements, and the post hoc Wilcoxon signed ranks tests showed that BLRI distance (median = 10; 95% confidence interval [CI], 7-11.2) was significantly larger than both standard Freer (median = 5; 95% CI, 4-6.2) and native (median = 3; 95% CI, 2-3) and that standard Freer was significantly larger than native (all p values <0.001).
CONCLUSION: BLRI is a safe, controlled technique that provides significantly greater medialization of the middle turbinate compared to standard medialization techniques. BLRI significantly enhances the operative space within the middle meatus.
Anne E Getz; Peter H Hwang
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-04
Journal Detail:
Title:  International forum of allergy & rhinology     Volume:  3     ISSN:  2042-6984     ISO Abbreviation:  Int Forum Allergy Rhinol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-09-09     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  101550261     Medline TA:  Int Forum Allergy Rhinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  231-5     Citation Subset:  IM    
Copyright Information:
© 2013 ARS-AAOA, LLC.
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MeSH Terms
Aged, 80 and over
Chronic Disease
Feasibility Studies
Middle Aged
Prospective Studies
Rhinitis / surgery*
Sinusitis / surgery*
Treatment Outcome
Turbinates / anatomy & histology,  surgery*
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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