The nasal turbinates are large, important structures in the nasal airway. There are two pairs of important turbinates, the inferior turbinates and the middle turbinates. Attention to the turbinates and correctly dealing with them can be the difference between success and failure in nasal surgery.
Inferior turbinate reduction surgery dates back to the 1890s. Turbinectomy later fell out of favor because of rising concern over complications such as rhinitis sicca, atrophic rhinitis, and ozena. The enlarged nasal cavity resulting from turbinate resection was believed to increase nasal airflow and reduce the humidifying capabilities of the nasal mucosa, resulting in drying, crusting, and mucosal atrophy. However, several studies have reported large series of turbinectomies without these complications.
There are several types of turbinate surgery:
All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a tiny, high-speed device (micro-debrider) is used to shave off the extra tissue. The surgery may be done through a lighted camera (endoscope) that is placed into the nose. You may have general anesthesia or local anesthesia with sedation so you are asleep and pain-free during surgery.
A tool is placed in the nose to change the position of the turbinate. This is called the outfracture technique. Some of the tissue may also be shaved off. You may have general anesthesia or local anesthesia with sedation so you are asleep and pain-free during surgery.
Radiofrequency or Laser Ablation:
A thin probe is placed into the nose, and laser light or radio energy goes through this tube and shrinks the turbinate tissue. The procedure can be done in the doctor’s office using local anesthesia.
Why the Procedure is Performed
Our physicians may recommend this procedure if:
You are having trouble breathing through your nose because the airways are swollen or blocked, and other treatments, such as allergy medicines, allergy shots, and nose sprays, have not helped.
Before the Procedure
During the days before your surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), and any other medicines that thin your blood.
- Ask our physicians which medications you can take on the day of your surgery.
On the day of your surgery:
- You will be asked not to drink or eat anything after midnight the day of your surgery.
- Take the medicines our physicians prescribe with a small sip of water.
After the Procedure
Many patients have good short-term relief from radioablation. Symptoms of nasal blockage may return, but many patients will have better breathing for at least two years after the procedure.
Almost all patients who have turbinoplasty with a micro-debrider will still have improved breathing three years after surgery. Some patients will no longer require the need to continue nasal medications.
- You will go home on the same day as surgery.
- You will have some discomfort and pain in your face for two to three days.
- Your nose will feel blocked until the swelling goes down.
- We will show you how to take care of your nose during your recovery.
- You will be able to go back to work or school the day after surgery.
- You can return to your normal activities after two weeks.
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