Answer
Sinus CT scanning is useful for delineating the extent of disease in patients who have underlying chronic rhinosinusitis or acute recurrent rhinosinusitis. Anatomic relationships between the middle turbinate, the septum, and lateral nasal wall may also be useful in the evaluation of nasal headaches. Preferred scans are those in a coronal plane with 2- to 3-mm thickness and bony windows. Contrast is not helpful. See Nasal Cavity Anatomy, Physiology, and Anomalies on CT Scan.
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Media Gallery
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Normal-sized right inferior turbinate with a moderate inferior septal deflection.
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Bony hypertrophy of the right inferior turbinate following topical vasoconstriction.
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Mucosal hypertrophy of the right inferior turbinate with total airway obstruction.
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Mucosal hypertrophy of the left inferior turbinate with impingement of the septum and narrowed nasal airway.
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A stab incision is made at the anterior head of the inferior turbinate. Blunt dissection beneath the mucoperiosteum elevates tissue for subsequent microdebridement. The microdebrider is turned in all directions, but mucosa is entirely preserved. Video courtesy of Vijay R Ramakrishnan, MD.
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