different surgeries
Hi Dr., Could you quickly explain the difference between Bilateral Inferior Turbinoplasty, IT bone excision, and IT submucosal microdebrider treatment? Which do you think is the best? My ENT did Inferior Turbinoplasty for me and he swears by it, saying he's been doing it 15 years with no complaints (says he takes out only enough turb to open the nasal a cavity a tiny bit, leaving more than 95% of the IT. But what are your thoughts on it? Thanks.

turbinoplasty is a vague term that can mean a whole host of things, but generally it implies slitting the lining, taking away some bone (and some mucosa), and letting the surface swing down to form a smaller turbinate (soor, probably needs pics to understand) IT bone excision would be basically as above - not sure of a distinction there IT submucosal microdebrider means a suction-shaver is used to resect the vascular tissue from below the lining = lining is preserved Since your doc offers a "turbinoplasty" which is a vague term it is hard to comment on. Whichever technique is used though, mucosal preservation is of paramount importance.

My ENT said that it was not sub-mucuosal, and he used Jansen-Middleton biting forceps to do this and he prefers this to the microdebrider. This made me very nervous because some mucousal lining was lost. He said that he only removes a minimal amount at the very tip, he estimates 3 or 4 % of the entire IT. I'm a little confused because he told me that as I heal, the lining will grow back around the tip. Is this not correct? Does mucosal lining "grow back"? I thought it did not? Or is he just talking about tissue lining? I'm very confused and nervous. He is an ENT at a top hospital in New York that specializes in ear nose and throat surgery, but I am a month post-op and I don't know who to believe or what to believe.

He is talking about resecting the tip of the IT. I suggest you read through this site to get a better understanding of turbinate resection.

Doctor, I have not been able to find much about IT tip resection. Are there a lot of ENS patients that result from this type of operation (even a small bit of the tip of the turbinate being resected)? A lot of the posts or info that I see on this site involve people who have had extensive turbinate reduction. Is it possible to have damage to the air flow receptor nerves, etc. that would cause these breathing difficulties, or is it more likely that the breathing difficulties are from the crusts? Thank you.

ENS is not a certain outcome with tip (requires mucosal) resection, but possible. Hence, I cannot endorse such surgery.