PSReport 0706
PATIENT NAME:
MR #:
SURGEON:
DATE OF SURGERY:
Cynthia Mancini
059-332
Jack C. Einhorn, MD
03/10/2014
PREOPERATIVE DIAGNOSES
1. Chronic nasal obstruction secondary to septal deviation.
2. Turbinate hypertrophy.
POSTOPERATIVE DIAGNOSES
1. Chronic nasal obstruction secondary to septal deviation.
2. Turbinate hypertrophy.
NAME OF OPERATION
1. Septoplasty.
2. Submucous resection of inferior turbinates bilaterally.
ANESTHESIA
General via endotracheal tube.
INDICATIONS
The patient is a 35-year-old woman with a history of chronic nasal obstruction for the past
several years. Her symptoms were refractory to multiple medical therapies.
FINDINGS
C-shaped deflection of the nasal septum to the left side with approximately 80% obstruction of
the left naris. In addition, there was a right maxillary crest spur with approximately 60%
obstruction of the right nasal passage. The inferior turbinates were hypertrophied bilaterally.
PROCEDURE
After adequate general endotracheal anesthesia had been achieved, the patient was placed in
supine position. A 4% cocaine solution was applied topically, and 2% Xylocaine with 1:100,000
epinephrine was injected subcutaneously to assist with local hemostasis. The patient was
prepared and draped in the usual sterile fashion. The inferior turbinates were out-fractured
bilaterally. A left hemitransfixion incision was made, and carried through the underlying septal
cartilage. A left mucoperichondrial flap was elevated. Quadrilateral cartilage was incised at its
point of maximal deflection, and bilateral mucoperiosteal flaps were elevated. The deviated
portions of the perpendicular plate of the ethmoid were removed using septal scissors and
rongeurs. Overlapping inferior quadrilateral cartilage was incised. The right maxillary crest and
vomerine spur were removed using Takahashi forceps. Additional septal cartilage was trimmed
to allow the C-shaped deformity to be corrected. Inspection revealed correction of the nasal
septal deformity. Patent nasal airways were present bilaterally. Plain gut 4-0 was used to place a
(continued)
OPERATIVE REPORT
PATIENT NAME: Cynthia Mancini
MR #: 059-332
DATE OF SURGERY: 03/10/2014
Page 2
running plication suture to approximate the right and left nasal mucosa. Interrupted 4-0 chromic
was to close the hemitransfixion incision.
The inferior turbinates were in-fractured bilaterally. The anterior and inferior aspects of the
inferior turbinate mucosa were cauterized and incised. The mucosa was elevated off the medical
and lateral aspects of the inferior turbinate bone. The inferior turbinate bone was then resected
using Takahashi forceps. Redundant mucosa was also excised sharply. Hemostasis was achieved
using suction and Bovie cautery.
After hemostasis was assured, Telfa impregnated with 1% hydrocortisone cream was placed in
the nasal cavity bilaterally as nasal packing. A drip pad was placed and the procedure terminated.
The patient tolerated the procedure well.
ESTIMATED BLOOD LOSS
10-15 mL.
COMPLICATIONS
None.
___________________
Jack C. Einhorn, MD
JCE/ps
D: 03/10/2014
T: 03/10/2014