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What are Turbinates?

Turbinates, structures of scroll-like bone and soft tissue on the side of your nose’s inner wall, help filter, moisten, and warm airflow as it travels through your nose on its way to the lungs. When the soft tissue of the turbinates becomes enlarged (known as turbinate hypertrophic) and touches the nasal passages, blocked airflow results, making it difficult to breathe through your nose.

Enlarged turbinates are among the most common causes of nasal obstruction. Of the several types of turbinates, those known as the “inferior” are those most likely to become enlarged.

Causes may include allergies, environmental irritants, deformity of the nasal septum, and/or or sinus inflammation.

How Do You Know If Your Turbinates are Enlarged?

Symptoms that may indicate that you have enlarged turbinates include:

  • Blocked or congested breathing through your nose
  • Difficulty breathing at night
  • Snoring
  • Ongoing nosebleeds
  • Chronic sinus infections

Treating Enlarged Turbinates

Treatment of the underlying allergy or irritant with the use of medications such as nasal steroid sprays may reduce turbinate swelling. If medicines fail, turbinate reduction surgery –cauterization, coblation, radiofrequency reduction, microdebrider resection, or partial resection, depending on the obstacle to breathing – may be necessary.

As with any major surgery, risks include infection, bleeding, and possible adverse reaction to the anesthetic. In addition, the following may occur:

  • Bleeding, occurs to some degree in most nasal surgeries, rarely becoming significant
  • Symptoms that persist, or show no improvement
  • Infection, rare
  • Toxic Shock Syndrome, life-threatening, but extremely rare
  • Numbness of teeth and nose, almost always resolved within months
  • Septal perforation (hole in the nasal septum), rare
  • Altered sense of smell or taste
  • Change in voice resonance/quality
  • Swelling/bruising in eye region

In evaluating your suitability for turbinate reduction, your surgeon will a take a detailed medical history, conduct a physical exam and look into your nasal passages with a slim lighted instrument called an endoscope.

It is important that you and your doctor discuss your expectations of what turbinate reduction surgery will accomplish.

What Happens During Turbinate Reduction Surgery?

If you and your physician determine that you are a good candidate for the surgery, local or general anesthesia will be used, depending on your and your surgeon’s preferences and on the procedure’s complexity. Discuss with your doctor beforehand which kind of anesthesia is best for your case.

Local anesthesia means that a pain-numbing medication is injected directly into your nasal tissues; this often includes a drug for sedation injected through an IV (intravenous line) during the procedure, making you groggy, but not unconscious.

With general anesthesia, you will either inhale a painkilling agent or receive one through an IV; this will affect your entire body and induce a temporary state of unconsciousness.

Depending upon your case, your turbinate reduction may be performed as either an outpatient procedure or in the operating room.

Your surgeon will make an incision in the lining (mucosa) of the turbinate to remove its underlying bone. Various surgical methods are used in turbinate reduction surgery, depending on the circumstance: one removing neither bone or tissue, another only a portion (small or large), and one leaving the turbinate lining intact.

Despite the fact that turbinate tissue is known to sometimes regrow following surgery, it is never removed entirely, as complete elimination may result in a permanent dry and crusty nose. The point of the surgery is to eliminate your nasal obstruction problems with no disturbance of the turbinate’s natural function.

Before you go home, your physician will provide you with instructions concerning care, physical and daily activities, and diet. To minimize the chances of bleeding and swelling and to help assure the most positive outcome, make certain that you follow these to avoid complications.

Otolaryngology (Ent) Surgeons

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