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Nose Reduction Surgery
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Question: Who here has had surgery for turbinate reduction?
I don't mean intermediate measures for reducing swollen turbinates such as
somnoplasty, freezing, cautery, or laser reduction. I mean real surgery with
a knife, cutting out part of the turbinate.
I have had two laser reduction procedures and two somnoplasties, and still
have problems with swollen turbinates. An ENT I went to recently said that
it's because the bone on one side is also overgrown, not only the mucosa. So
the only thing that would work is standard knife surgery.
But he didn't seem very enthusiastic about it. Said there can be problems
with it, over-drying of nose, etc. Results aren't always good. Nose has to
be packed afterwards (which sounds terrible to me), and one has to stay home
for a week. So he didn't recommend it, although he said it's the only option
for reducing my swollen turbinates.
I should mention that steroid sprays do nothing for me, although I've used
them for years. The only medicine that works in reducing the swelling is
oxymetazoline (Afrin), which shouldn't be used regularly.
So, I would like to hear others (patients and doctors) experience with this
surgery. Results, side-effects, recovery, etc.
Answer: Turbinates are baffles that extend from the outer walls of the right & left
nasal cavities into the cavity or airway itself. They help to control air flow &
humidify/warm inhaled air. They are composed of a core of bone (a shelf of bone
protruding out of the wall) & are covered by mucosa. If the bone is too large
&/or the mucosa swollen the airway will be blocked preventing air flow through
that side of the nose. The sinus cavity on that side of the face may also be
blocked so it can't drain. This can cause sinusitis, sinus headaches, etc.. If
the problem is intermittent i.e. comes & goes it most likely is due to swollen
mucosa which swell on exposure to pollutants, pollens & other airborne
irritants. If this is the problem avoidance of irritants & nasal drops/sprays
should suffice.
If the problem is constant it is most likely due to excess bone & surgical
debulking of the turbinate is required. The entire turbinate need not be removed
& most of the mucosa should be spared to prevent a dry nose with bleeding etc.
after surgery. A sheet of plastic is placed between the septum in the middle of
the nose & the sidewall from which the turbinate has been debulked. This
prevents scar tissue from forming between the raw surface on the turbinate & the
septum. If this scar tissue forms it can also hamper air flow. Packing is not
required you only need something to prevent the scar tissue bridge from forming.
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