Hi doctor, I am a 23 year old women from Ohio who under went orthognathic surgery ( osteotomy lefort 1 impaction) 3 months ago, and i have a little question, is it frequent that surgeons preform a septoplasty and a bilateral turbinectomy during the surgery without discussing it with the concerned patient prior to performing the procedure? i mean, i found that i had it done on the surgery discharge paper i received prior to leaving the hospital? Just found a little weird that's all. Thanks
Is It Common With Septoplasty To Also Have Bilateral Turbinectomy?
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Doctor Answers 4
Very common to perform both at the same time
The turbinates play an equally important role in blocking your breathing passage as the septum does. In a great majority of cases I perform a turbinate reduction at the same time as the septoplasty. The patients are always told of that possibility prior to surgery.
It's possible that after moving your upper jaw (Lefort 1) they found your passages where being blocked at the new jaw position and felt obligated to do e other procedures to allow you to breath. You should definitely discuss it with them.
Septoplasty with Turbinectomy
It is very common to have these two procedures performed concomitantly to improve the nasal airway. However, it is somewhat surprising to have had them together with a maxillary osteotomy without having it discussed by your surgeon ahead of time. If the procedures were done to facilitate the osteotomy, it makes sense, but usually this possibility is mentioned preoperatively. Hopefully, your result was good, but you might want to ask your surgeon about it at your next visit. I'm sure he'll be happy to explain it to you.
Procedures without consent
Although most consent forms usually allow for surgeons to do what they think is necessary during a procedure if it is the patient's best interest. I am surprised that your surgeon did not discuss the possibility of this occurring prior to your procedure. A surgeon usually will tell their patient about all possible adjunct procedures that might be necessary and the associated risks and benefits of those additional procedures prior to the surgery. You might wish to ask your surgeon if doing these procedures at the same time at the maxillary osteotomy is standard in his practice. The procedures you mentioned are relatively minor and have a low risk profile but it would be worth having the discussion. It may be that the consent forms you signed actually mentioned those procedures but this may not have been brought to your attention.
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Septoplasty and turbinate surgery with maxillary osteotomy
Usually these are done as a separate procedure from the maxillary osteotomy. But if the maxilla is moved upward, sometimes the turbinates and septum have to be reduced to allow for the movement needed. Usually this is part of the maxillary osteotomy and not coded separately. Hopefully this answers your question. Donald R. Nunn MD, DDS Atlanta Plastic Surgeon.
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