Have you ever heard of Turbinate Reduction? It is a treatment that reduces the size of your turbinates. Turbinates are structures in the nose that can cause nasal obstruction when enlarged, inflamed, or infected. By reducing their size, patients experience less frequent episodes of sinusitis and chronic rhinosinusitis as well as significantly reduced nasal congestion day and night. The success rate for this procedure varies from person to person. This article will discuss how Turbinate Reduction is performed, its success rate, causes, and treatment methods.
What Is Turbinate Reduction Surgery?
Turbinate reduction is a surgical procedure that reduces the size of nasal turbinates. The turbinates are a set of three bony shelves on each side of the nose covered by nasal mucosa. That mucosa helps filter, humidify and warm the air getting to the lungs through your nose. The inferior and middle turbinates are the only ones that are responsible for congestion and sinus issues. When the turbinates are enlarged or inflamed, turbinate reduction is done to treat turbinate hypertrophy. Turbinate hypertorphy besides a deviated septum and nasal valve collapse are the main causes of chronic nasal congestion, poor sleep quality, snoring, breathing problems, chronic sinus problems and sinus headaches. Turbinate Reduction surgery removes excess tissue from the turbinates to improve airflow.
What Affects the Success Rate of Turbinate Reduction Surgery?
The success of turbinate reduction surgery will depend on the cause of turbinate hypertrophy as well as the expertise of the surgeon who does the procedure and what technique is used to perform the procedure. Its success rate will also be affected by age, whether or not your nasal passages are narrow, if sinusitis is present, if one suffers from underlying allergies and if one also has a deviated septum or nasal valve collapse as well. Lastly the technique used for turbinate reduction is critical.
Age plays a pivotal role in determining the success of turbinate reduction surgery. Turbinate hypertrophy is more common in younger people than it is in older people. Younger patients also have a higher success rate because their nasal passages are wider and less likely to be narrowed by inflammation or scar tissue from previous infections. Narrow nasal passages make turbinate reduction surgery more difficult.
If the turbinates are enlarged due to an infection, there will usually be symptoms like yellow discharge through one nostril and fever with chills that last for five days or longer. If this condition persists, then you’ll need antibiotics before undergoing any surgical procedure.
There’s a greater chance that your sinuses won’t drain properly if you suffer from chronic sinusitis, which may result in persistent congestion or post-nasal drip following surgery.
Typical Problems Associated with Enlarged Turbinates
Turbinates are part of the nose’s anatomy that can cause several problems for people. These include:
An inflammation or infection in the tissues lining your nasal cavity (sinuses) which often causes facial pain, nasal stuffiness, fever, and headaches. It may be caused by turbinate swelling due to allergies or other factors such as bacterial infections or chronic non-allergic (irritant induced) rhinosinusitis.
When the turbinates are swollen patients will experience severe nasal congestion during the day and night and sometimes only at night. They often say it switches from side to side and feels like a constant cold. This is worsened if patients also have a deviated septum or enlarged turbinates as well.
Snoring or Sleep Disturbance
Many patients with turbinate hypertrophy will also complain of chronic nasal congestion which leads to chronic mouth breathing, dry mouth, snoring and various sleep issues as well. As such after turbinate reduction, many patients experience more restful sleep with decrease snoring permanently.
Factors Contributing to Turbinate Swelling
Environmental allergens may irritate and inflame your nasal tissue. When this happens, you will often experience symptoms such as a runny or congested nose and itching inside the nose. Other symptoms include trouble breathing through either nostril (especially at night), post-nasal drip with thick mucus, and difficulty sleeping. You can combat these effects by using an antihistamine medications (sprays or pills) or even saline spray for relief. However when symptoms are severe and lasting for over 3 months, procedures may be warranted.
Smoking is a significant cause of turbinate swelling and can also be worsened by it. Since it’s an irritant, smoking decreases the blood flow to your nose, so you are more likely to snore or have trouble breathing through either side of your nose at night, as well as other symptoms like congestion and sinus pressure.
Smoking not only harms your health in general but causes issues with sleep apnea, which can often lead to swollen nasal passages due to less oxygen reaching the lungs. This means that if you smoke while experiencing sleep apnea, then these effects will worsen even further.
Changes in Temperature and Humidity
A change in temperature and humidity can also cause swollen turbinates, as your nose is more sensitive to these factors. Your nasal turbinates will experience irritation that will make them swell and affect normal airflow and breathing.
Treatment Methods for Turbinate Reduction
Various surgical methods reduce turbinates, including laser treatment, microdebrider-assisted reduction, electrical cauterization, and coblation-assisted reduction.
Turbinate reduction through laser surgery is a commonly used treatment and can be done in the office. The procedure works by killing the turbinates’ cells from the inside, thus reducing their size and volume. It often is associated with many recurrences needing to have the procedure repeated over and over in many patients. It also often causes scarring and crusting in the nose for a long period. Patients should attend a follow-up visit to ensure that there has been a sufficient reduction of the turbinates and more reduction is not necessary.
Microdebrider-Assisted Submucous Reduction (Dr. Cohen’s Expert Technique and Best Results in all published long-term studies)
The microdebrider-assisted submucous reduction is the gold standard for permanent turbinate reduction. It is performed in the office under local anesthesia in under 15 minutes by Dr. Cohen. It is a permanent method to reduce the turbinate bone without affecting the functional mucosa on top of the turbinate. The results are amazing and in less than 1% of patients needs to ever be repeated. Patients who have had their procedure done report less congestion, less sinus problems, better sleep, easier breathing, and improved quality of life.
Under electrical cauterization, the turbinate is cut and burned in order to cause scar tissue and less inflammation of the turbinates. Nonetheless it’s associated with significantly slower healing and scar tissue formation and crusting in the area for months to come. Patients must understand all aspects of a surgical process to know what to expect after recovery occurs.
Coblation-assisted turbinate reduction is a procedure that is done to reduce the size of turbinates. It involves using a probe placed in the nostril to emit a high-frequency, low amplitude radio frequency (RF) energy which ablates the mucosa and the head of the turbinates and shrinks its size. This procedure is easy and done in the office as well in under 15 minutes, however is often not permanent and may need to be repeated in many patients.
We hope this post has helped provide you with some information about turbinate reduction and the success rates. Dr. Alen N. Cohen, M.D. F.A.C.S. at Southern California Sinus Institute, is a world-renowned award-winning expert in all nose and sinus conditions and has a full range of services and products available for your sinus needs, including turbinate reduction surgery. Contact him today if you have any other questions or would like to set up an appointment for a consultation.