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Submucous resection inferior turbinate, partial or complete, any method

CPT4 code

Name of the Procedure:

Submucous resection of the inferior turbinate, partial or complete, any method ("turbinate reduction" or "turbinoplasty")

Summary

A submucous resection of the inferior turbinate is a surgical procedure to reduce the size of the inferior nasal turbinates. These are structures inside the nose that can become enlarged and can obstruct nasal airflow, leading to breathing difficulties.

Purpose

This procedure addresses nasal obstruction due to enlarged inferior turbinates, which can be caused by allergy, chronic sinusitis, or other conditions. The goal is to improve nasal airflow and alleviate associated symptoms like congestion and difficulty breathing.

Indications

  • Chronic nasal congestion that does not respond to medical treatment
  • Difficulty breathing through the nose
  • Chronic sinusitis
  • Sleep disturbance due to nasal obstruction
  • Snoring or obstructive sleep apnea

Preparation

  • Fasting for at least 6 hours before the procedure if general anesthesia is to be used.
  • Adjusting or stopping certain medications as advised by the doctor, particularly blood thinners.
  • Preoperative diagnostic tests, such as a nasal endoscopy or CT scan of the sinuses, if necessary.

Procedure Description

  1. The patient is given either local or general anesthesia.
  2. A small incision is made inside the nose to access the turbinate.
  3. Specialized instruments, such as a microdebrider or radiofrequency device, are used to remove or shrink tissues from the turbinate, while preserving the mucosal lining.
  4. The turbinates are carefully restructured to promote better airflow.
  5. The incision is closed, usually with dissolvable stitches.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The surgery is performed in a hospital operating room, outpatient clinic, or surgical center.

Personnel

  • An ENT (Ear, Nose, and Throat) surgeon
  • Anesthesiologist or nurse anesthetist
  • Surgical nurses and support staff

Risks and Complications

  • Bleeding
  • Infection
  • Scarring
  • Crusting inside the nose
  • Persistent nasal dryness
  • Changes in sense of smell
  • Need for revision surgery in rare cases

Benefits

  • Improved nasal airflow
  • Reduced nasal congestion
  • Better breathing through the nose
  • Improved sleep quality
  • Enhanced quality of life

Recovery

  • Patients can often go home the same day.
  • Pain is usually mild and managed with over-the-counter pain relievers.
  • Nasal congestion may persist for a few weeks due to swelling.
  • Saline nasal sprays or rinses may be recommended to promote healing and reduce crusting.
  • Follow-up appointments with the surgeon to monitor healing.

Alternatives

  • Medical management with nasal corticosteroids or antihistamines
  • Radiofrequency ablation without surgical resection
  • Balloon sinuplasty
  • Other surgical procedures like septoplasty (if nasal septum deviation is a contributing factor)
  • Each alternative has its pros and cons; for instance, medical management might not be as effective for severe cases but is non-invasive.

Patient Experience

Patients may experience some discomfort and congestion immediately after the procedure. Full recovery and realization of benefits typically occur within a few weeks. Pain management typically includes over-the-counter pain medications, and comfort measures such as humidifiers and saline sprays can aid in recovery.

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