PMID- 24415461
OWN - NLM
STAT- MEDLINE
DCOM- 20141113
LR  - 20160511
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 4
IP  - 4
DP  - 2014 Apr
TI  - Incidence of middle turbinate lateralization after axillary flap approach to the 
      frontal recess.
PG  - 333-8
LID - 10.1002/alr.21265 [doi]
AB  - BACKGROUND: The axillary flap approach (AFA) to the frontal recess improves 
      visualization and clearance while minimizing use of angled endoscopes. However, 
      some argue that it destabilizes the middle turbinate (MT) and increases risk of 
      MT lateralization (MTL). We aimed to establish rates of MTL after AFA, as well as 
      to determine whether other surgical or disease factors affect lateralization. 
      METHODS: This study was a retrospective chart review. Endoscopic postoperative 
      videos between 3 and 9 months (short-term) and greater than 9 months (long-term) 
      were reviewed blind to surgery performed. Presence of MTL, ability to pass an 
      endoscope into the middle meatus, and ability to evaluate the frontal recess were 
      recorded. Surgical characteristics obtained from the chart review included: MT 
      conchopexy, septoplasty, concha bullosa, and primary vs revision surgery. Patient 
      characteristics included age, sex, polyposis, asthma, and smoking. Cases were 
      excluded if the MT was absent. RESULTS: A total of 124 patients (248 operated 
      sides) were included in the short-term cohort. Similar numbers of primary (52.4%) 
      and revision (47.6%) cases were performed, 42.3% had polyposis, and 38% 
      asthmatics. Overall rate of MTL was 14.5%, with an inability to examine the 
      frontal recess in 12.1%. Suture conchopexy of the MT through the septum did not 
      affect lateralization. Results were statistically similar in the long-term 
      cohort. CONCLUSION: The AFA yielded a 14.5% and 17.4% MTL in the short-term and 
      long-term cohorts, respectively. This rate appears consistent with reports in the 
      literature that did not use the axillary flap. No patient or surgical factor was 
      found to affect rates of lateralization.
CI  - (c) 2014 ARS-AAOA, LLC.
FAU - Chen, Philip G
AU  - Chen PG
AD  - Department of Surgery-Otorhinolaryngology, Head & Neck Surgery, University of 
      Adelaide, Adelaide, Australia.
FAU - Bassiouni, Ahmed
AU  - Bassiouni A
FAU - Wormald, Peter-John
AU  - Wormald PJ
LA  - eng
PT  - Journal Article
DEP - 20140110
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
SB  - IM
MH  - *Endoscopy
MH  - Female
MH  - Frontal Sinus/*surgery
MH  - Humans
MH  - Male
MH  - Postoperative Complications
MH  - Postoperative Period
MH  - *Surgical Flaps
MH  - Turbinates/pathology/*surgery
OTO - NOTNLM
OT  - FESS
OT  - chronic rhinosinusitis
OT  - endoscopic sinus surgery
OT  - middle turbinate
OT  - middle turbinate lateralization
OT  - rhinosinusitis
OT  - sinus anatomy
OT  - sinus surgery
EDAT- 2014/01/15 06:00
MHDA- 2014/11/14 06:00
CRDT- 2014/01/14 06:00
PHST- 2013/08/05 00:00 [received]
PHST- 2013/10/17 00:00 [revised]
PHST- 2013/11/05 00:00 [accepted]
PHST- 2014/01/14 06:00 [entrez]
PHST- 2014/01/15 06:00 [pubmed]
PHST- 2014/11/14 06:00 [medline]
AID - 10.1002/alr.21265 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2014 Apr;4(4):333-8. doi: 10.1002/alr.21265. Epub 2014 
      Jan 10.