Reducing the size of the inferior turbinates helps improve nasal congestion.
The turbinates are normal structures inside the nose. When they are enlarged, they can cause nasal congestion.
The inferior turbinates are thought to help warm, humidify, and filter the air we breathe through our noses. When the turbinates become too large, they can make it difficult to breathe through the nose. Many patients with enlarged turbinates get better with medications. For example, nasal steroid sprays can help decrease some of the swelling and can help patients breathe better through the nose. Patients who do not get better with medications can find relief with surgery.
Surgery is typically called turbinate reduction or turbinate resection. Patients can choose to have the surgery in the office or in the operating room. In many instances, enlarged turbinates are only one part of the problem. Some patients also have problems like a deviated nasal septum. In these cases, patients may have procedures like septoplasty at the same time they have their turbinates reduced.
It is important that the turbinate not be removed completely because its removal can result in a very dry and crusty nose. In the absence of a turbinate, the air that is breathed may not be to adequately humidified and warmed.
There are many ways to shrink the size of the turbinates.
Examples of different types of procedures used for enlarged turbinates are cauterization, coblation, radiofrequency reduction, microdebrider resection, and partial resection. All of these terms refer to treatments that can reduce the size of the turbinates.
A procedure called "submucosal resection" has been shown to be a very effective way of treating patients with enlarged turbinates. This type of surgery involves removing some of the "stuffing" from the inside of the turbinate. The surface of the turbinate is what allows the turbinate to perform its normal functions. So, with this type of surgery, the surface of the turbinate is not removed.
To perform the procedure, Dr. Goyal makes a small incision at the front of the turbinate. He then removes some of the soft tissue and bone that make up the inside of the turbinate. The turbinate is sculpted from the inside to help reduce its size. The turbinate is also pushed out towards the side of the nose using a procedure called "outfracture." These procedures allow patients to breathe much more comfortably because they create more space inside the nose for airflow.
The pictures below show how a turbinate's size and shape changes at the time of surgery.
Recovery after turbinate surgery usually lasts less than a week.
Most patients have pain, fatigue, nasal stuffiness, and nasal drainage after surgery. Pain is generally very mild with this type of surgery. Most patients tell us that they have to take only a few doses of their pain medicine during the entire postoperative period.
Most patients find that they are very stuffy right after surgery from the swelling after the procedure. This typically starts to improve about a week after surgery. Patients typically have drainage of some mucus and blood from your nose after surgery. This is a normal part of the healing process.
After surgery, we recommend that you use saline sprays and nasal rinses. You can find sprays and rinse kits at most pharmacies. Our patients find the NeilMed Sinus Rinse kit easy to use. You can find out more information about the kit at www.neilmed.com.
For more information about turbinate surgery…
Dr. Goyal has written several articles and book chapters on the inferior turbinates and surgery to treat enlarged turbinates. Please see these links for more information:
- Information on our website about the diagnosis of turbinate hypertrophy.
- Dr. Goyal's article for the American Rhinologic Society website on septoplasty and turbinate surgery can be found at http://care.american-rhinologic.org/septoplasty_turbinates
- Dr. Goyal's has written two book chapters about septoplasty and turbinate surgery:
- Goyal P, Hwang PH. Septal & turbinate surgery. In: Kountakis S & Onerci M, eds. Rhinologic and Sleep Apnea Surgical Techniques. Springer Verlag, Berlin, Heidelberg, New York, 2007
- Goyal P & Hwang PH. Septal and turbinate surgery. In: Kennedy DW & Hwang PH, eds. Rhinology: Diseases of the nose, sinuses, and skull base. Thieme, New York, 2012.