Clinical Indicators: Inferior Turbinate Surgery

1. History (required)
   1. Chronic nasal obstruction due in part to inferior turbinate hypertrophy.
   2. Failure of directed medical management with continued nasal symptoms (medications, allergy treatment, and duration of therapy).
   3. Failure of medical treatment of rhinitis medicamentosa.
   4. Symptoms of obstructive sleep apnea.
2. Physical Examination (required)
   1. Inferior turbinate description before and after decongestion.
   2. Description of nasal anatomy, documenting presence or absence of other intranasal pathology.
3. Tests (optional)
   1. Allergy evaluation.
   2. Rhinomanometry
   3. Acoustic rhinometry

Postoperative Observations

1. Bleeding–change gauze dressing as needed.
2. Pain–if severe or worsening.
3. Packing or internal splint optional–is it in desired location?
4. Monitor for toxic shock syndrome.

Outcome Review

1. One Week
   1. Healing–Was treatment required for bleeding or infection?
2. Beyond One Month
   1. Airway–Is the presenting problem improved?
   2. Are there problems with crusting?
   3. Are there problems with sinusitis?
   4. Are there problems with ozena/atrophic rhinitis?

Associated ICD-10-CM Diagnostic Codes (Representative, but not all-inclusive codes)

• H04.419 Chronic dacryocystitis of unspecified lacrimal passage
• H04.411 Chronic dacryocystitis of right lacrimal passage
• H04.412 Chronic dacryocystitis of left lacrimal passage
• H04.413 Chronic dacryocystitis of bilateral lacrimal passages
• J34.3 Hypertrophy of nasal turbinates
• G47.30 Sleep apnea, unspecified

Additional Information

Assistant Surgeon — N
Supply Charges — N
Anesthesia Code(s) — 00160

Patient Information

Turbinate cauterization involves treatment of a portion of the membrane of an enlarged inferior turbinate to reduce its size. Partial turbinate resection involves removal of a portion of bone and sometimes the mucous membrane of an enlarged inferior turbinate. It is a safe and effective procedure to relieve nasal congestion which has not improved with treatment of other underlying nasal, sinus, and/or allergy problems. Inferior turbinate procedures are performed under local or general anesthesia, sometimes employing cautery, laser, cryotherapy or radio frequency ablation. They may be performed in association with other nasal and or sinus procedures. Post-operative bleeding may occur. Nasal sprays and lubrications may be prescribed to relieve dryness and aid in healing. Long term complications that may be associated with turbinate surgery include bleeding, crusting, dryness, odor, scarring, and sinusitis.

Important Disclaimer Notice (Updated 8/7/14)

Clinical indicators for otolaryngology serve as a checklist for practitioners and a quality care review tool for clinical departments. The American Academy of Otolaryngology—Head and Neck Surgery, Inc. and Foundation (AAO-HNS/F) Clinical Indicators are intended as suggestions, not rules, and should be modified by users when deemed medically necessary. In no sense do they represent a standard of care. The applicability of an indicator for a procedure must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical indicators will not ensure successful treatment in every situation. The AAO-HNS/F emphasizes that these clinical indicators should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. The AAO-HNS/F is not responsible for treatment decisions or care provided by individual physicians. Clinical indicators are not intended to and should not be treated as legal, medical, or business advice.

CPT five-digit codes, nomenclature and other data are copyright 2009 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein.

© 2010 American Academy of Otolaryngology-Head and Neck Surgery.