Turbinate Reduction

Overview

Turbinate reduction, also known as nasal or inferior turbinate reduction, is a surgical procedure performed by Ear, Nose, and Throat (ENT) specialists to improve airflow in individuals with persistent nasal congestion. When the procedure is done on both sides of the nose, it is called bilateral turbinate reduction.

Reasons for undergoing the procedure

Turbinate reduction surgery involves removing excess tissue from around the turbinate bones to enhance breathing. Turbinates are small structures inside the nose that cleanse, warm, and humidify the air as it passes through the nasal passages to the lungs. These structures can become swollen and inflamed due to irritation, allergies, or infections. Although this swelling is typically temporary, some individuals may suffer from chronic enlargement of the turbinates, a condition known as hypertrophy.

Risks

Following turbinate reduction surgery, one may:

• Nosebleeds.
• Chronic nasal dryness.
• Empty nose syndrome, an uncommon condition in which you are unable to sense airflow via your nasal passages.

Discuss the risks associated with turbinate reduction with your doctor. They can assist in deciding if the surgery is appropriate for you.

Before the procedure

To decide if turbinate reduction is needed, your doctor will start with a physical examination and may perform a nasal endoscopy to examine the inside of your nose more closely. Typically, they will first suggest treatment with steroid nasal sprays or antihistamines. If these treatments do not alleviate the symptoms, turbinate reduction surgery may be considered. This procedure is usually recommended if nasal obstruction leads to problems like congestion, post-nasal drip, sleep apnea, or other breathing difficulties.

During the procedure

Turbinate reduction surgery can be done at an outpatient clinic, hospital, or ambulatory surgical center on the same day. While some patients may just require local anesthetic, the treatment is often carried out under general anesthesia.

Your surgeon will gently shrink your turbinate tissue during turbinate reduction surgery. There are a few methods that can be used to do this, including:

• Cauterization: A heated probe is inserted into the nose to seal some of the blood vessels in the turbinates. This reduces blood flow and causes the turbinate tissue to shrink.
• Radiofrequency turbinate reduction: This method uses a thin probe to deliver radiofrequency energy to the inflamed turbinates, creating scar tissue that causes the tissues to shrink.
• Coblation: Short for “controlled ablation,” this technique also uses heat energy to reduce the size of the turbinates but at a lower temperature, preserving the surrounding tissues.
• Microdebrider submucosal resection: The surgeon makes a small incision in the turbinate to remove tissue while leaving the outer lining intact. As the area heals, the turbinate tissue shrinks.
• Partial resection: Involves removing a small portion of the turbinate, including both soft and hard tissue, unlike the other methods that primarily focus on soft tissue reduction.

After the procedure

After your turbinate reduction surgery, your doctor will provide detailed postoperative instructions. To ensure a smooth recovery, follow these tips. You may experience some crusting in your nose, which is normal as your turbinates heal and can last up to three weeks. To ease this, use a cold mist humidifier or saline nasal spray. Alternatively, you can apply petroleum jelly around your nose to help with discomfort.

Outcome

If the procedure is performed in the office, you can typically return to work, school, and other normal activities the next day. However, if it’s done under general anesthesia, you will need about a week to recover. Complete recovery from turbinate reduction may take as little as six weeks, during which your doctor will monitor your progress to ensure you’re healing properly.

Overall, turbinate reduction has a success rate of about 82%. While the tissue around your turbinates may regenerate over time, many people find that the benefits of the procedure are highly satisfying.