Fig. 20 Infracture of the inferior turbinate. A periosteal elevator is slipped into the inferior meatus and advanced along the length of the inferior turbinate. The patient's head is stabilized and the turbinate is pushed medially by distributing force along the entire length of the turbinate rather than just at one point. This step creates a larger space for the exit of tears from the nasolacrimal duct and minimizes trauma. The instillation of oxymetazoline (Afrin, Schering, Liberty Corners, NJ) into the inferior meatus before this maneuver will reduce intraoperative and postoperative bleeding.