What Are Turbinates?
The turbines are structures within the nasal passageway. Each nostril has three turbinates, which are each made of bone and soft tissue. These three turbinates are the Inferior turbinates, Middle turbinates, and the Superior turbinates. These structures sit near the septum, the cartilage and bone divide that separates the nostrils.
The septum is covered with a mucosal lining that, along with the turbinates, helps maintain warmth and moisture in the air as it passes through the nose. Because the turbinates are situated directly in the nasal passages, enlargement can lead to obstructed breathing.
Enlarged (Hypertrophied) Turbinates
One or more of the three turbinates in the nostrils may become enlarged as a result of inflammation. In some cases, the turbinates enlarge as a reaction to seasonal allergens.
Sometimes, enlargement is caused by environmental irritants. Chronic sinusitis, which causes persistent inflammation in the nasal passages, may also trigger chronic swelling of the turbinates.
“Dr. Gould is motivated to understand his patient’s needs. He wants to correctly address the patients issue rather than simply trying a procedure to see what the impact is. The staff is friendly and they operate efficiently to mitigate long wait times. I’ve had two sinus procedures performed by Dr. Gould and his bed side manner is a model all doctors should strive for.” – M.L.
Symptoms Of Enlarged Turbinates
Chronic nasal obstruction or a stuffy nose, is often caused by enlargement (hypertrophy) of the inferior turbinate. Congested nasal obstruction can impair normal breathing, forcing patients to breathe through the mouth and often affects their daily activities.
Enlarged turbinates and nasal obstruction can also contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep.
Causes Of Enlarged Turbinates
Common causes may be:
- Environment irritants (such as cigarette or cigar smoke)
- Pregnancy or other hormonal changes
- Aging process
- Congenital variations
Diagnosing Inferior Turbinate Hypertrophy
At the St. Louis Sinus Center, a diagnosis of inferior turbinate hypertrophy can usually be made at your first visit. This may include:
- A thorough review of symptoms
- An ENT examination
- A Nasal Endoscopy
- A MiniCAT CT Scan
How Are Enlarged Turbinates Treated?
Treatment for chronically enlarged turbinates is developed on a case-by-case basis. Some patients may be able to manage this problem with proper medications such as nasal antihistamine sprays or nasal corticosteroid sprays.
These medications temporarily reduce swelling. When enlarged turbinates are causing nasal obstruction and difficulty breathing through the nose, a surgical procedure may be a more appropriate treatment. An ear, nose, and throat doctor may consider several techniques to reduce the size of the turbinates. Two common options include Radiofrequency Ablation and Submucosal Reduction.
Radiofrequency Ablation (RFA)
Radiofrequency Ablation is an outpatient office procedure that shrinks the turbinate by gently heating the submucosal lining between the turbinate and the septum. This is achieved with low-power radiofrequency energy directed into the tissue using a small probe inserted through the nostril.
While it can take several minutes for the local anesthesia to numb the nasal passages, the RFA treatment itself is completed in 10 minutes or less.
Submucosal Reduction (SMR)
Submucosal Reduction is an outpatient procedure that is performed in a surgical center with general anesthesia. It may coincide with a surgical septoplasty to further improve breathing.
The procedure is performed using an endoscope, a thin tube that has a light at the end. Using the endoscope to visualize the inferior turbinate, the surgeon made a small incision in the mucosal lining of this structure. The underlying bone is removed and the tissue around the turbinate may be thinned using a small instrument. Alternatively, radiofrequency or electrical current may be used to cauterize this tissue, causing shrinkage.
Septal Deviations – In patients with a septal deviation is it not uncommon for both sides of the nose to be blocked. A common scenario would be that one side of the nose is blocked from the deviated septum and on the other from inferior turbinate hypertrophy.
Allergies – Allergies can cause swelling, often leading to turbinate hypertrophy.
Colds and Infections – Cold or infection may cause congestion due to enlarged turbinates. In most cases, the turbinates will return to their normal size after recovery. However, in some instances such as chronic sinusitis, the enlargement may be permanent.
Will Swollen Turbinates Go Away On Their Own?
Swollen turbinates may be manageable without surgical intervention in some cases. Suggested strategies include:
- Do not smoke- Smoking causes inflammation in the nasal passages and throughout the body. While this habit may not cause the turbinates to enlarge, it can exacerbate breathing difficulties.
- Perform saline nasal lavage- The nasal passages can accumulate mucus and bacteria. To wash substances away, many people rinse the nasal passages with saline nose drops. A solution can be made of 1 teaspoon of baking soda, 1 teaspoon of salt, and 2 cups of distilled water. This solution can be added to a bulb syringe or neti pot, both of which are used to stream the fluid into the nose. Excellent care of the syringe or neti pot is necessary to prevent bacteria from accumulating in them. Cleaning and care guidelines must be strictly followed.
- Use a humidifier or vaporizer in rooms to support adequate nasal lubrication.
- Use over-the-counter nasal sprays or medications as directed- The overuse of certain types of medications can have an adverse effect that worsens nasal obstruction.
Is Swollen Turbinate Treatment Painful?
Treatments for enlarged turbinates are performed using an appropriate anesthetic. The nerves in the nasal passages are numbed and do not transfer pain signals to the brain, allowing patients to tolerate their procedure very well.
“Very professional, respectful, & kind. Dr. Gould and his wonderful team are great; he knows clearly any issues, shows care, and he did a great job with my sinus problem. I am glad that I finally found a good professional in this area. Very happy with the appointments, the schedule, the reminders. Thank you for your wonderful service” – C.R.
Schedule A Consultation
If you’re interested in learning more about Turbinates and how we treat it, please call 314.473.5433 to schedule a consultation with our experienced team at our office’s in St. Louis and Festus, MO. You can change your life with nose surgery and you can take the first step by speaking with us.