Facial Plast Surg 2020; 36(03): 235-241
DOI: 10.1055/s-0039-3401803
Original Research
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Piezo-Assisted Turbinoplasty: A Novel Rapid and Safe Technique

Enrico Robotti
1   Private Practice—Plastic Surgery, Bergamo, Italy
,
Ali Khazaal
2   Bagdad–ORL, Bagdad, Iraq
,
Francesco Leone
1   Private Practice—Plastic Surgery, Bergamo, Italy
› Author Affiliations
Funding The authors received no financial support for publication of this article.
Further Information

Publication History

Publication Date:
31 December 2019 (online)

Abstract

Consensus is still lacking on the ideal treatment of turbinate hypertrophy concurrent with rhinoseptoplasty. A novel technique of turbinoplasty consisting of incision-bone fracturing by the use of piezoelectric technique—intramucosal microcauterization—lateralization is described in detail. A series of 157 consecutive patients is reviewed with a maximum follow-up of one year. The technique is fast and easy and allows predictability in avoiding postoperative bleeding and preventing remedialization of the lateralized turbinates. Due to the technology required, its use is suggested especially when piezo is employed during other steps of rhinoseptoplasty.

 
  • References

  • 1 Bergmark RW, Gray ST. Surgical management of turbinate hypertrophy. Otolaryngol Clin North Am 2018; 51 (05) 919-928
  • 2 Downs BW. The inferior turbinate in rhinoplasty. Facial Plast Surg Clin North Am 2017; 25 (02) 171-177
  • 3 Sinno S, Mehta K, Lee ZH, Kidwai S, Saadeh PB, Lee MR. Inferior turbinate hypertrophy in rhinoplasty: systematic review of surgical techniques. Plast Reconstr Surg 2016; 138 (03) 419e-429e
  • 4 Tanna N, Im DD, Azhar H. , et al. Inferior turbinoplasty during cosmetic rhinoplasty: techniques and trends. Ann Plast Surg 2014; 72 (01) 5-8
  • 5 Hol MK, Huizing EH. Treatment of inferior turbinate pathology: a review and critical evaluation of the different techniques. Rhinology 2000; 38 (04) 157-166
  • 6 Jackson LE, Koch RJ. Controversies in the management of inferior turbinate hypertrophy: a comprehensive review. Plast Reconstr Surg 1999; 103 (01) 300-312
  • 7 Rohrich RJ, Krueger JK, Adams Jr WP, Marple BF. Rationale for submucous resection of hypertrophied inferior turbinates in rhinoplasty: an evolution. Plast Reconstr Surg 2001; 108 (02) 536-544 , discussion 545–546
  • 8 Jun BC, Kim SW, Kim SW, Cho JH, Park YJ, Yoon HR. Is turbinate surgery necessary when performing a septoplasty?. Eur Arch Otorhinolaryngol 2009; 266 (07) 975-980
  • 9 Han JK, Stringer SP, Rosenfeld RM. , et al. Clinical consensus statement: septoplasty with or without inferior turbinate reduction. Otolaryngol Head Neck Surg 2015; 153 (05) 708-720
  • 10 Berger G, Hammel I, Berger R, Avraham S, Ophir D. Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 2000; 110 (12) 2100-2105
  • 11 Rudes M, Schwan F, Klass F, Gassner HG. Turbinate reduction with complete preservation of mucosa and submucosa during rhinoplasty. HNO 2018; 66 (02) 111-117
  • 12 Egeli E, Demirci L, Yazýcý B, Harputluoglu U. Evaluation of the inferior turbinate in patients with deviated nasal septum by using computed tomography. Laryngoscope 2004; 114 (01) 113-117
  • 13 Lee DC, Jin SG, Kim BY. , et al. Does the effect of inferior turbinate outfracture persist?. Plast Reconstr Surg 2017; 139 (02) 386e-391e
  • 14 Aksoy F, Yıldırım YS, Veyseller B, Ozturan O, Demirhan H. Midterm outcomes of outfracture of the inferior turbinate. Otolaryngol Head Neck Surg 2010; 143 (04) 579-584
  • 15 Buyuklu F, Cakmak O, Hizal E, Donmez FY. Outfracture of the inferior turbinate: a computed tomography study. Plast Reconstr Surg 2009; 123 (06) 1704-1079
  • 16 Rohrich RJ, McKee D, Malafa M. Closed microfracture technique for surgical correction of inferior turbinate hypertrophy in rhinoplasty: safety and technical considerations. Plast Reconstr Surg 2015; 136 (05) 607e-611e
  • 17 Moss WJ, Lemieux AJ, Alexander TH. Is inferior turbinate lateralization effective?. Plast Reconstr Surg 2015; 136 (05) 710e-711e
  • 18 Wolfswinkel EM, Koshy JC, Kaufman Y, Sharabi SE, Hollier Jr LH, Edmonds JL. A modified technique for inferior turbinate reduction: the integration of coblation technology. Plast Reconstr Surg 2010; 126 (02) 489-491
  • 19 Nassif Filho AC, Ballin CR, Maeda CA, Nogueira GF, Moschetta M, de Campos DS. Comparative study of the effects of submucosal cauterization of the inferior turbinate with or without outfracture. Rev Bras Otorrinolaringol (Engl Ed) 2006; 72 (01) 89-95
  • 20 Passàli D, Lauriello M, Anselmi M, Bellussi L. Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy. Ann Otol Rhinol Laryngol 1999; 108 (06) 569-575
  • 21 Larrabee YC, Kacker A. Which inferior turbinate reduction technique best decreases nasal obstruction?. Laryngoscope 2014; 124 (04) 814-815
  • 22 Padgham N, Vaughan-Jones R. Cadaver studies of the anatomy of arterial supply to the inferior turbinates. J R Soc Med 1991; 84 (12) 728-730
  • 23 Orhan M, Midilli R, Gode S, Saylam CY, Karci B. Blood supply of the inferior turbinate and its clinical applications. Clin Anat 2010; 23 (07) 770-776
  • 24 Lee HY, Kim HU, Kim SS. , et al. Surgical anatomy of the sphenopalatine artery in lateral nasal wall. Laryngoscope 2002; 112 (10) 1813-1818
  • 25 Orhan I, Aydın S, Ormeci T, Yılmaz F. A radiological analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography. Am J Rhinol Allergy 2014; 28 (01) e68-e72
  • 26 Akoğlu E, Karazincir S, Balci A, Okuyucu S, Sumbas H, Dağli AS. Evaluation of the turbinate hypertrophy by computed tomography in patients with deviated nasal septum. Otolaryngol Head Neck Surg 2007; 136 (03) 380-384
  • 27 Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106 (01) 106-114
  • 28 Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC. American Academy of Oral and Maxillofacial Radiology. Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113 (06) 817-826
  • 29 Gerbault O, Daniel RK, Kosins AM. The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 2016; 36 (01) 21-34
  • 30 Murchison AP, Pribitkin EA, Rosen MR, Bilyk JR. The ultrasonic bone aspirator in transnasal endoscopic dacryocystorhinostomy. Ophthal Plast Reconstr Surg 2013; 29 (01) 25-29