The forgotten turbinate: The role of the superior turbinate in endoscopic sinus surgery

The fate of the middle turbinate in endoscopic sinus surgery has been a sub ject of debate for some rime. The superior turbinate's role, however has be en largely passed over Past anatomic descriptions and illustrations have gi ven surgeons the incorrect impression that this structure is well superior and out of the field of dissection. Injury to the superior turbinate may ac count for postoperative hyposmia. The superior turbinate also serves as a c onstant landmark for the sphenoethmoidal recess, and a limited resection al lows the surgeon to identify and include the natural ostium of the sphenoid sinus in the sphenoidotomy. The embryology and anatomy of the superior tur binate are reviewed. Art approach to the natural ostium of the sphenoid sin us from the lateral side of the middle turbinate, using the superior turbin ate as a guide, is described.