Turbinate Hypertrophy Treatment
Learn about the methods for treating turbinate issues and the every-day impact it can have on patient’s lives. Dr. Reddy offers his expertise as an otolaryngologist to inform you of the risks and reward of the various treatment options for enlarged turbinates.
What is Turbinate Hypertrophy?
Turbinate are these heating humidifying structures along the side wall of the nose. They exist on both sides of the nose and their purpose is for heating, humidification and filtering out all dirt, dust, pollen, debris. Hypertrophy occurs when you get enlargement of those turbinates, which can lead to nasal obstruction and blockage of the airways. That enlargement can lead to many issues and symptoms.
Symptoms of Enlarged Turbinates
The main issue of enlarged turbinates is breathing obstruction. They take up too much room in the nose and patients complain of a clogged nose on one side, both sides, or alternating. Obstructed breathing is a key symptom of enlarged turbinates. They can also lead to sleeping problems and breathing issues when laying down.
When laying in a supine position (on your back) your heart pumps blood more easily through the nose, which can lead to engorged, swollen turbinates. This obstructed nasal pathway creates breathing problems which lead to sleep issues.
Treatment Options for Enlarged Turbinates
One of the first treatments to try is saline irrigation. Flushing out allergens like dirt and pollen decreases reactivity to allergens that trigger swelling in the turbinates. The salt water solution helps to support the nose’s natural cleaning mechanisms as well. Thinner mucus is easily transported by Celia, which sweeps music up and out of the sinuses and into the back of the throat to decrease inflammation from allergens and dust. This treatment can expand to include various saline sprays, irrigation, and steroids that are over the counter and in some cases prescription.
Steroids & Sprays
Nasal steroids are best used under the guidance of an ENT who can identify your level of obstruction and create an individualized treatment plan for you. Over the counter decongestant sprays can provide short-term relief, but can lead to larger problems with prolonged use. Afrin and others, quickly shrink the blood vessels in the turbinates to make them smaller overall. However, your body and nose are intelligent, and get used to the effects of the spray, eventually making the blood vessels larger in that area to offset the effects of the Afrin or other spray. The short term relief is diminished by the fact that your turbinate’s blood vessels are much larger now than they were weeks or months ago. So, to conclude, steroid sprays are a great option for treating nasal obstruction, but consult with an ENT to avoid complications like Rhinitis Medicamentosa.
The turbinate is made out of a lining with mucosa and bone underneath. Surgical treatments for enlarged turbinates typically reduce one or both of those things to make more room in the area. There are many ways to address turbinate issues surgically, and Dr. Reddy evaluates all options because each patient is different. Depending on the cause of the symptoms, there are various surgical options, each with their own set of risks and rewards.
Risks for turbinate surgery include short and long-term bleeding and removing too much mucosa or bone during the procedure.
For the first three weeks or so, there is an increased risk of nosebleeds, about 2- 3%. There is also more crusting for the first several weeks. The crusting will stop all by itself, once the lining totally remucolsalizes, the bleeding risk again goes away within three weeks, once the lining resurfaces. The risk of taking out too much turbinate is something called empty nose syndrome or Ozena.
This controversial syndrome doesn’t affect everyone the same, but the theoretical risk here is that there is too much room created inside the nose. One would assume that this results in better breathing, but in truth you have less resistance. Your nose likes to feel a little bit of resistance, and you also have less nerve endings to feel the air going into your nose. So, even though more air is moving through the nose, you can’t feel it. This very troublesome condition makes a patient’s nose feel stuffy, although there is air moving in and out.
Other Non-Surgical Treatment Options
Conservative (non-surgical) treatment options are always explored first. Dr. Reddy offers many outpatient procedures with minimal pain or interference so address nasal obstruction before considering surgery.
Radiofrequency ablation of the turbinates shrinks the mucosa with a tiny radiofrequency probe that changes their shape. There is also a new treatment called the Acclarent tract balloon. Essentially you just put the balloon in your nose, we inflate it, and it pushes your turbinate over to the side. It might also move over any tiny slight septal deviations over to the other side. While these methods may not have as long term of an effect as surgery, they offer a great option for patients that prefer to have low, shorter downtime and avoid general anesthesia. Contact our office to find out how your breathing issues can be addressed at our office with out-patient procedures.