Preventive Measures of Middle Turbinate Lateralization After Endoscopic Sinus Surgery: An Updated Review

Introduction: The middle turbinate (MT) is the most important anatomical structure inside the nasal cavity and a landmark in the identification of skull base, ethmoid cells, and lamina papyracea. Postoperatively, lateralizationof the MT can cause synechia and obstruction of the middle meatus and the maxillary, ethmoid, or frontal sinuses. Objective: To review the current literature about the outcome of different techniques used intraoperatively to prevent lateralization of MT after functional endoscopic sinus surgery (FESS). Materials and methods: This retrospective narrative literature review provides a summary of current and past research publications about different techniques used intraoperatively to prevent MT lateralization after FESS. Results: Many methods have been described to prevent the lateralization of MT and synechiae formation. These methods include controlled synechiae, suture lateralization, metal clips, partial resection of MT, middle meatus implants, and steroid-eluting implants and stents. Conclusion: The ideal FESS should include preservation of the MT, reducing its lateralization, and preventing synechia formation.Different techniques have been discovered in an attempt to prevent this complication.