Turbinates (aka Concha) are bony projections that come from the sides of the nasal cavity.  There are typically 3 turbinates.  The lower most turbinate called the inferior turbinate is the largest and, when enlarged, has the greatest impact on the nasal airway.  The turbinates bones are covered by mucosa with rich vascular, erectile tissue (yes, ED meds can make that swell too!) and plays an important role in humidifying, cooling, warming, and directing the air.    

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When turbinates become chronically engorged or dysfunctional, a procedure to reduce their size can help.

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There are many variations of the procedure.  Outdated technique involving removal of the turbinate has been largely abandoned due to high risk of empty nose syndrome which can result in chronic nasal crusting, dryness, and paradoxic congestion.  Modern technique focuses on preservation of function while relieving the congestion by preservation of the important functional surface, the mucosa of the turbinate.  The reduction is limited to reducing the size of the underlying bone or erectile tissue.  The instruments available include coblation, turbinator, micro-debrieder, and traditional instrumentation.  The technique chosen depends upon the characteristics of your turbinate.

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Requisites

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Turbinate surgery may be an option for you if your evaluation reveals a turbinate problem.

Following requisites are important prior to undergoing the procedure.

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• You are in reasonably good health with no critical unstable medical condition.

• You have had an evaluation with a qualified surgeon to determine appropriateness of the procedure. 

• You have discussed the procedure with your surgeon and understand potential risks & benefits of the procedure.

• Be able to stop blood thinning medications prior to the procedure.

 

 

Risks of Turbinate Reduction

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Although every surgery and treatment has risks, good news is that the procedure can be very safely performed for most with exceedingly small risk of serious complications.  Risks include the following.

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• Bleeding and infection.  Universal risk with all surgeries.  Some blood tinged nasal drainage is typical during recovery.  Severe bleeding and infection are rare. 

• Pain.  Typically the pain is very mild and well controlled with ibuprofen with tylenol if needed.

• Smell disturbance.  Temporary difficulty smelling may occur due to swelling but resolves quickly.  Permanent disturbance is rare.

• Numbness of upper teeth/lips.  Temporary numbness may occur.  Permanent numbness is rare. 

• Need for further treatment.  Remaining congestion due to allergies or other problems will need continued treatment.  Other unexpected outcome may require additional treatment. 

• General Anesthesia if applicable.  Although risk is not zero, modern anesthesia is overwhelmingly safe.  Nausea and other anesthesia related problems may occur and may need further treatment.

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What to expect

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• Procedure is performed in the office under local anesthesia or under general anesthesia in the operating room.

• Most patients are discharged home the same day to convalesce at home.

• Light physical activity (walking) is encouraged during the recovery period. 

• You should avoid blowing your nose, heavy lifting or strenuous activities. 

• Keeping the head of the bed elevated during sleep helps.

• You will be using nasal saline spray to keep the nostril area clear of mucus and debris. 

• Improvement is often immediate but may take 6-8 weeks depending on the technique used.