Turbinate Reduction
Treatment for Turbinate Hypertrophy
What Are Turbinates?
The turbinates are structures within the nasal passageway. Each nostril has three turbinates, which are each made of bone and soft tissue. These structures sit on either side of the septum, the cartilage and bone divide that separates the nostrils. The turbinates are covered by respiratory epithelium covering a thick layer of vascular tissue. The epithelium layer is also the first line of immunological defense, triggering a quick immune response at the signs of microbial or chemical irritation. This vascular tissue swells at set intervals during normal circumstances, but can become chronically inflamed or enlarged.
The septum is covered with a mucosal lining that, along with the turbinates, helps warm, filter, and humidfy the air as it passes through the nose. The turbinates are located in the front of the nose and if enlarged, can lead to obstructed breathing.
Causes of Enlarged (Hypertrophied) Turbinates
- Inflammation – often from allergic rhinitis/hayfever.
- Environmental irritants
- Chronic sinusitis, which causes persistent inflammation in the nasal passages, may also trigger chronic swelling of the turbinates.
- Pregnancy and hormonal changes
- Aging Process
- Congenital causes
- Colds and Infections – typically this is temporary, but on some occasions this can result in permanent enlarged turbinates
Symptoms Of Enlarged Turbinates
- Chronic nasal obstruction or a stuffy nose.
- Nasal Congestion, often worse at night
- Runny nose
- Mouth breathing
- Dry Mouth
- Headaches
- Difficulty sleeping
- Septal Deviations – In patients with a septal deviation is it not uncommon for both sides of the nose to be blocked. It is common for a patient to have one side of the nose blocked from the deviated septum and the other side from inferior turbinate hypertrophy.
Diagnosing Inferior Turbinate Hypertrophy
Our clinical specialists will evaluate you with a comprehensive history and physical examination. This may include any of the following:
- A thorough review of symptoms
- An ENT examination
- A Nasal Endoscopy
- A CT Scan
How Are Enlarged Turbinates Treated?
Treatment for chronically enlarged turbinates is developed on a case-by-case basis. Some patients may be able to manage this problem with proper medications other patients may require an in office procedure.
There are several medications available which include:
- Nasal steroids sprays
- Nasal antihistamine sprays
- Nasal saline irrigations
- Oral decongestants
- Oral Steroids
These medications temporarily reduce swelling.
If you are also experiencing allergic rhinitis, allergy testing and treatment with immunotherapy can significantly improve your symptoms.
Other ways to help reduce turbinate swelling:
- Do not smoke- Smoking causes inflammation in the nasal passages and throughout the body. While this habit may not cause the turbinates to enlarge, it can exacerbate breathing difficulties.
- Perform saline nasal rinses/irrigations- The nasal passages can accumulate irritants. Rinsing these irritants away from the nasal lining, helps prevent swelling. To wash substances away, many people rinse the nasal passages with saline rinses. A solution can be made of 1 teaspoon of baking soda, 1 teaspoon of salt, and 2 cups of distilled water. This solution can be administered to the nose through a bulb syringe or neti pot, Excellent care of the syringe or neti pot is necessary to prevent bacteria from accumulating in them. Cleaning and care guidelines must be strictly followed.
- Use a humidifier or vaporizer in rooms to support adequate nasal lubrication.
- Use over-the-counter nasal sprays or medications as directed- The overuse of certain types of medications can have an adverse effect that worsens nasal obstruction.
When enlarged turbinates are causing nasal obstruction and difficulty breathing through the nose, a surgical procedure may be a more appropriate treatment. Our physicians may consider techniques to reduce the size of the turbinates.
Submucosal Reduction (SMR)
Submucosal Reduction is an outpatient procedure that is performed in either in our office with topical medications or in a surgical center with general anesthesia. It may coincide with a surgical septoplasty to further improve breathing.
The procedure is performed using an endoscope, a thin tube that has a light at the end. Using the endoscope to visualize the inferior turbinate, the surgeon made a small incision in the mucosal lining of this structure. The underlying bone is removed and the tissue around the turbinate may be thinned using a small instrument.
What Will My Recovery Be Like After Turbinate Reduction Surgery?
Your recovery is individual, based on how much excess tissue your physician removes and whether your turbinate surgery was combined with another sinus-opening procedure such as balloon sinus dilation.
Typically the recovery from these procedures is well tolerated. You’ll be stuffy for a few days to a week, but your breathing will probably be better already. Your turbinates that were reduced will swell and you will likely have some yellow or bloody crusts for a week or so. You may have some bloody discharge for the first 3-5 days, but this varies by the patient. Patients say the area is uncomfortable, but they don’t describe it as painful. You’ll take extra-strength Tylenol and that should be sufficient. You may be congested and feel as if you have a bad cold.
You’ll need to keep blood pressure to your face to a minimum to aid healing. Take it easy for the first week, and then gradually increase your activity. You may resume all of your normal activities 2 weeks after surgery. Most patients only need a few days off work after turbinate reduction surgery.
Is Turbinate Reduction Surgery Safe?
This is a safe procedure. Our providers use the most minimally invasive methods for these turbinate procedures. There can be some postoperative bleeding and bloody discharge, but this can be limited by the use of nasal saline mist spray every 2-3 hours. We will provide you will all the instructions on how to care for your nose after this procedure. This is a very successful, safe procedure.