Vascular Anatomy of the Inferior Turbinate and Its Clinical Implications. Issue 5 (September 2020)

• Record Type: Journal Article
• Authors: Scott, John R.; Psaltis, Alkis J.; Wormald, Peter-John
• Is Part Of: American journal of rhinology & allergy. Volume 34:Issue 5(2020)
• Page Start: 604
• Page End: 609
• Publication Date: 2020-09
• Subjects: inferior turbinate -- vascular -- turbinate reduction -- anatomy -- blood supply -- bleeding -- descending palatine artery -- branching; Nose -- Periodicals; Allergy -- Periodicals; 616.21005
• DOI: 10.1177/1945892420914185
• Languages: English
• ISSNs: 1945-8924

Abstract

Background: Published reports on the vascular anatomy of the inferior turbinate (IT) are limited. Historical papers report the IT artery as a tributary off the posterior lateral nasal artery (PLNA), but this has not been our clinical experience. Objective: The purpose of this study was to examine the arterial blood supply to and the branching pattern within the IT. We discuss this is the context of IT surgery and relate it to postoperative bleeding complication rates. Methods: Endoscopic dissection was performed on 16 cadaver heads (24 sides) to determine the origin of the IT artery. Intraoperative surgical videos were analyzed in 50 patients to uncover the vascular branching pattern within the IT. A retrospective review of bleeding complications in patients undergoing IT reduction surgery was also conducted. Results: In 17 of 24 sides (70.8%), the IT artery arose either exclusively (54.2%) or partly (16.6%) off the descending palatine artery (DPA). As a branch off the DPA, the IT artery exited the pterygopalatine fossa through a foramen located 7.7 ± 3.0 mm from posterior edge of the IT, 8.4 ± 3.1 mm above the nasal floor and 1.6 ± 2.1 mm below the insertion of the IT bone onto the lateral nasal wall. The mean number of arteries cascading within the IT was 2.7 ± 0.5. Moreover, 112 patients underwent IT reduction surgery and 2 (1.8%) experienced postoperative epistaxis. Conclusion: The IT artery has major contributions from the DPA. Most commonly 3 arteries branch within the IT. Knowledge of this vascular anatomy may minimize bleeding associated with IT reduction surgery.