Swing technique for middle turbinate preservation in expanded endonasal skull base approaches

Abstract

Endoscopic endonasal approaches to the middle fossa and orbital apex have traditionally included resection of the middle turbinate to improve visualization and operating space. The aim of this publication is to demonstrate a surgical technique that affords similar visualization and space but preserves the middle turbinate. We describe a technical modification that allows for conservation of the middle turbinate and describe an illustrative case. As current surgical techniques evolve towards progressively less morbidity, preservation of anatomic structures such as the middle turbinate will be pursued. In the case described, middle turbinate preservation did not negatively affect access or visualization and did not appear to alter postoperative wound healing. With middle turbinate preservation, the principle function of airflow conditioning and potential neural regeneration are maintained.

Keywords: endoscopic orbital surgery; endoscopic skull base surgery; middle turbinate; orbit; orbital apex.