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The turbinates are the bony structures on either side of the nose. The turbinates are covered with soft erectile tissue called “nasal mucosa”. These turbinates warm, humidify and purify the air that we breathe. They can swell in response to allergies or sinus infections. When they get large enough to block your breathing this is called “turbinate hypertrophy“. If medication and environmental precautions do not reduce the turbinate size and allow you to breathe well through your nose, you may need a turbinoplasty. Anything that reduces the size of the turbinates to help you breathe better is termed a “turbinoplasty.”
There are four types of turbinates inside the nose. From the bottom of the nose to the top are the inferior, middle, superior and supreme turbinates. The largest is the inferior turbinate that extends along the floor from the front to the back of the nose. Turbinoplasty is only used to reduce the size of the inferior turbinates. The middle turbinate can be reduced as well but this is called a “concha bullosa resection.”
There are many effective techniques to reduce hypertrophied turbinates. Some methods shrink or remove the nasal mucosa surrounding the bone of the turbinate, some remove the turbinate bone, and some remove both turbinate bone and soft tissue. The technique used will depend on how big your turbinates are and if they are obstructive due to the bone or due to the soft tissue.
The following is a list of techniques used to reduce hypertrophied turbinates that range from simple crushing the bone of the turbinate laterally, to completely remove the turbinate.
Since both the left and the right side of the nose have turbinates, and these turbinates are exposed to the same allergies and sinus infections, they both are frequently enlarged. They can be reduced on either side of the septum. The same, multiple or different techniques can be used to reduce the bilateral turbinates.
Septoplasty is straightening of the deviated nasal septum, the wall that divides the left and right sides of the nose. Making the nasal septum less deviated may bring the septum closer to one or both of the turbinates. If you have a deviated septum and turbinate hypertrophy you would want both of these procedures performed at the same time whenever possible.
The procedure can be performed in the office, in an ambulatory surgery center, or in the hospital. Local or general anesthesia may be used meaning you may be able to choose to be awake or asleep during the surgery. The procedure can be combined with other procedures such as septoplasty, sinus surgery, or repair of a nasal fracture. You generally go home about an hour after the turbinoplasty.
You will tend to be stuffy for a few days to a week although some people breathe better right away. The turbinates tend to swell and you can have some yellow or bloody crusts for a few weeks. The turbinates are mildly uncomfortable but rarely painful. The worst part of recovery is the congestion that sometimes feels like a bad cold. Depending on the technique used, you may want to limit your exertion for a couple of weeks to decrease the chances of bleeding. Saline rinses will help to heal by washing away some of the crusting. With the correct turbinoplasty and proper postoperative care, you should be breathing better than before your procedure in just a few short weeks!