On 5/27/05 5:31 AM, in article dr2e911qbkq1r9m3qih39mt6ar8ktu329f@4ax.com,

Here is the problem from the surgeon's point of view.
Patient has a deviated septum - not 100%, he has antrum blockage, he has
enlarged turbinates. He has some polyps.
Its is fine to try all manners of medical treatment, but according to the
films, when you get through, he still has antrum blockage. So, after weeks
or longer of Rx you still have to do the surgery to prevent further disease.
It is poor medicine to put someone through months of Rx needlessly.

If you are going to open the antrum you don't really have to do the
turbinates and the septum. BUT, what if months later the patient still has
problems and you decide you should have done the septum and the turbinates?
How do you feel about bringing the patient back to surgery with the ENORMOUS
expense, etc etc. because you made the wrong decision and didn't do the
turbinates?
The name of the game is to do as little surgery as possible, getting the
patient well, but you also don't want to end up doing a second surgery
because you, essentially, failed the patient.
For most surgeons, the "additional surgery " is done because we don't want
the patient to have to return for a second trip to the OR. So, we do the
turbinates in order to avoid this possibility. The septum is a tough call.
Many patients get along fine with some deviation. But you have to decide, if
you are doing other surgery, whether its best to leave the septum deviated
and risk another surgery some day, or not.
I have done many adenoid surgeries and left the tonsils because I felt
tonsil surgery wasn't needed, despite the protest of the parents to do both.
Occasionally I made the wrong choice Fortunately, not often.