If you have chronic allergies, they may be making you miserable with what seems to be a permanently congested nose. You may have tried folk remedies, over-the-counter allergy medicines, and anything else you can find to relieve your suffering. Maybe it’s time to see a doctor about nasal surgery. Turbinoplasty and turbinectomy are both options that you can explore.
What Are Turbinates?
Turbinates are structures inside your nasal passages. They’re made of thin, bony plates covered by heavily vascularized soft tissue.
Each side of your nasal cavity has three turbinates, so there are six in all. The turbinates that are highest in the cavity are called the superior turbinates, the lowest ones are the inferior turbinates, and the middle turbinates are between the other two.
The purpose of turbinates is to condition the air that you breathe in through your nose. The air is warmed, humidified and, to some extent, filtered by the turbinates.
Why You Might Need Turbinoplasty or Turbinectomy
Anything that irritates the turbinates can cause the soft tissue to swell. Not only can this swollen tissue block the nasal cavity, but it also produces excess mucus. The result is that you feel as if your nose is constantly congested.
Chronic congestion is most often caused by allergies. Your doctor will first try to treat your condition with medicines, but if those are ineffective, turbinoplasty or turbinectomy may be an option. You shouldn’t leave the condition untreated since it can worsen and produce the following symptoms.
- Sleep apnea
- Sinus infections
- Repeated nosebleeds
What Is the Difference Between Turbinoplasty and Turbinectomy?
Turbinoplasty and turbinectomy are both procedures that reduce the obstruction caused by swollen inferior turbinates. The inferior turbinates are the largest of the three sets, and they’re the only ones that are treated with these procedures.
Turbinoplasty is done to reduce the size of the inferior turbinates without removing tissue. Turbinectomy is a procedure that removes some portion of the turbinate.
What Happens During Turbinate Surgery
If you are experiencing chronic congestion, your doctor will first do an endoscopic inspection of your nasal cavity. Your treatment will be determined by the results of this examination and the symptoms that you’re suffering.
Turbinoplasty and turbinectomy are performed under general anesthesia, so your doctor will give you pre-surgical instructions to follow before you come for the procedure. What happens during the procedure itself varies according to the option your doctor has chosen.
All procedures are done from inside the nose, so you won’t have any visible cuts or scars on your face. You should expect the surgery to take anywhere from 15 minutes to an hour.
- Turbinectomy. This is the option that removes the most tissue. It’s performed with a device called a microdebrider. A microdebrider is a small, high-speed medical device that shaves off thin layers of tissue.The microdebrider is sometimes used along with an endoscope. The tiny camera of the endoscope allows your doctor to clearly see the surgical field.
A microdebrider is very precise and lets your doctor remove the targeted tissue while leaving the rest undamaged. In some cases, the bony structures inside the inferior turbinates are removed with the microdebrider, letting the soft tissue collapse and shrink.
- Turbinoplasty. There are a couple of different ways that a turbinoplasty can be performed. One technique is called an “outfracture.”
The purpose of the outfracture technique is to reposition the turbinate rather than remove tissue from it. A round tool is inserted into the nose, and the turbinate is moved away from the septum. This usually compresses the bone inside the turbinate, so not only is it repositioned, it’s also smaller. Sometimes outfracture doesn’t give the amount of clearance you need, so your doctor will also remove a bit of the soft tissue.
An alternative to the outfracture procedure is to perform either radiofrequency or laser ablation. Both of these procedures use small instruments to deliver heat to the turbinate tissue. Scar tissue forms over the heated area, and this results in a shrunken turbinate.
- Follow-up Treatments. Occasionally, tissue grows back in the area from which it was removed. Your doctor can perform a secondary procedure to remove this tissue.
Your doctor’s goal is always to remove the smallest amount of tissue that will relieve your symptoms, so it’s better to risk needing a follow-up surgery than to have too much removed during the first procedure. You don’t want to end up with “empty nose syndrome,” which is a permanent, unpleasant sensation that makes it difficult for you to breathe through your nose.
What Happens After Turbinate Surgery
You’ll have a brief recovery period while the general anesthetic wears off, but most people are able to return home the same day. You should expect to have mild pain that can be relieved with over-the-counter pain medication.
For the first two or three days, your nose will be swollen, and it will feel stuffy. Once the swelling fades, you should begin to feel like getting back to your regular routine. Most people can return to work or school in about a week, and resume most normal activities after about three weeks.
You will have to avoid strenuous exercise for about a month to allow your nasal passages to fully heal, and you should experience complete recovery in about two months.
There are a few risks associated with turbinoplasty and turbinectomy, so if you experience any of these symptoms, talk to your doctor.
- Excessive bleeding
- Buildup of fluid
- Hole in septum
- Changes in olfactory senses
- Loss of sensation on skin of nose
Hudson Valley Sinus Center
The Hudson Valley Sinus Center, led by Dr. Ran Y Rubinstein, offers turbinate surgeries in the Hudson Valley area. Dr. Rubinstein is an ENT and facial plastic surgeon who is board certified by the American Board of Otolaryngology – Head and Neck Surgery and the American Board of Plastic Surgery.
Dr. Rubinstein is the only ENT in the Hudson Valley who specializes in nasal and sinus disorders. He is known for the natural results he achieves for both cosmetic and functional procedures.