The paper encourages the removal of MTs
A goal in ethmoid sinus surgery is to ventilate the sinuses by complete removal of all diseased tissue in the ostiomeatal complex. Many surgeons routinely preserve the middle turbinate because they feel it is not part of the disease process and its structure is very important for proper nasal physiology. Other surgeons frequently remove such to facilitate exposure to the ostiomeatal complex and, more importantly, they postulate that it is chronically diseased. This study involved 22 adult patients with CAT scan Stage 1:2, II:2, III:5, and IV:13 sinus disease who underwent intranasal ethmoidectomy with resection of the middle turbinate. Three additional turbinate resections performed for other reasons in patients with negative radiological findings served as controls. Histologic findings demonstrated the middle turbinate was chronically diseased to a similar degree as the ethmoids in all 22 patients. Respiratory mucosa without significant pathologic change was found in the controls. This suggests resection of the middle turbinate may be essential, especially in CAT scan Stage III and IV disease. Persistent disease in the middle turbinate may enhance the tendency for synechia formation with the lateral nasal wall and may also account for failure to relieve symptoms in some patients. The question of reversibility of disease in the middle turbinate following ostiomeatal complex surgery remains unanswered. (Am J Rhinology 8: 37-42, 1994) After reading it, I was so stunned. It sure can relieve the previous symptoms . But, how about the drainage and loss of sense of smell. What is your opinion? I still have MTs. I just feel sad to see these papaers.

Some patients with severe chronic hyperplastic rhinosinusitis(CHRS) may benefit from MT removal. With severe disease, severe measures are needed. I do not ever recall seeing an ENS patient with severe CHRS to start. ENS patients almost as a rule seem to have mild disease (recurrent acute rhinosinusitis, RARS?) that does not require MT resection during FESS. Or nasal obstruction that did not require the drastic step of IT resection.

Dr. HOUSER, you are really good!!!!!!!!
Dear Dr. Houser: Ever since the surgery I had 4 years ago, I did lots of research during my good time. And, I really feel that you really understand what ENS is. Also, many other sinus issues. YOU ARE REALLY GOOD!!!!!!!!!!!!!!!. People shall really go to see you for ALL sinus surgery. (THIS IS NOT A SCAM, personally, I don't know dr. houser at all, if you don't believe, you can call me 626-315-8170 to verify) But, it's too late for me. The surgery was done already. I noticed that, during my research, if the patient's MTs are very big and occupy the whole space, then the ENTs tend to remove them all. What is the MT is only bent, but still slim, what will the ENT do, straighten them by squeezing the bone, or reduce the size, when it is floppy, then move it toward the septum? THANKS If I visit you, for some revision surgery, without the general anaethesia, usually, how much will it cost? Could you email me?(leegustav@gmail.com) Because I don't have any insurnace, but I do believe some minor revision surgery can help me a lot now.

A bent turbinate is typically left alone. People have surmised in the past that a paradoxically bent MT may predispose to CRS, but most have moved away from this position. A paradoxically bent MT is NOT justification to remove it. Some will remove a floppy MT, but I think it wiser to leave it in place (fractured bone repairs), or Bolgerize the MT to the septum - a small scar created between septum and floppy MT to keep the MT in place. When I do a septal implant for ENS-MT I am simulating a bolgerized MT in my mind. I try to avoid getting mixed up in costs, but you could cal to inquire re: costs: sinus center at 216-518-3298 is more facile at producing costs, or metro at 216-778-8890. You could say the cost for an office visit with scoping, no surgery.