title: Concha bullosa: reducing middle meatal adhesions by preserving the lateral mucosa as a posterior pedicle flap.
abstract: BACKGROUND
  Concha bullosa, an extensively pneumatized middle turbinate, may obstruct the paranasal sinuses. Messerklinger's partial lateral turbinectomy is commonly used to debulk the concha bullosa, leaving a raw surface with the potential for adhesions.
  
  
  METHODS
  A modified technique of partial lateral turbinectomy is described. A posterior pedicled mucosal flap covers the inferior raw surface of the medial lamella of the middle turbinate. Three-month follow up of a consecutive series is compared with concurrent controls.
  
  
  RESULTS
  Two (7 per cent) of 28 posterior pedicled flap and four (21 per cent) of 19 traditional partial lateral turbinectomies developed mild middle meatal adhesions (p = 0.011). Posterior pedicled flap reduced the need for post-operative cleaning of the middle meatus.
  
  
  CONCLUSIONS
  The posterior pedicled mucosal flap is a simple modification to partial lateral turbinectomy that covers the raw surface facing the lateral nasal wall, significantly reducing adhesions and speeding recovery.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Monash Medical Centre, Clayton, Victoria, Australia.
authors.forename: Elizabeth A W
authors.initials: EA
authors.lastname: Sigston
authors.forename: Claire E
authors.initials: CE
authors.lastname: Iseli
authors.forename: Tim A
authors.initials: TA
authors.lastname: Iseli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D009297:Nasal Mucosa / Q000601:surgery*; D009668:Nose Diseases / Q000517:prevention & control*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D013524:Surgical Flaps; D000267:Tissue Adhesions / Q000517:prevention & control; D014420:Turbinates / Q000601:surgery*