Medical content: Op. Dr. Tamer Haliloğlu · Last updated:
What is Turbinate Surgery?
The structures called turbinates (conchae) are located on the side walls of the nose. The outer part of these structures consists of spongy soft tissue and the inner part of a bony skeleton. Turbinates are very rich in blood vessels. Their enlargement can lead to problems such as shortness of breath and snoring. Depending on these problems, turbinate surgery can be performed after certain examinations.
What is a Turbinate (Concha)?
There are three turbinates on each side, located in the lower, middle and upper parts of the nose. Their function is to warm, humidify, filter and conduct the air drawn into the lungs. Made up of bone and soft tissue, the turbinates fill their vessels with blood when the weather is cold. In this way they swell and make the air taken in through the nose ready for breathing.
What Causes Turbinate Enlargement?
In some cases, the lower and middle parts of the turbinates grow more than necessary. Turbinate enlargement is generally seen with a curvature of the nasal bone, in allergic reactions and in pregnancy. In addition to these conditions, some infections, some medications and environmental factors cause the turbinates to enlarge.
- Medications: Long-term use of nasal decongestants used to relieve nasal congestion in colds and flu causes the turbinates to enlarge and dry out.
- Allergic reactions: When people with allergies breathe air containing pollen, dust, house dust or mold, the turbinates swell and stay swollen (edematous) for a long time. When allergic reactions recur, after a while they cause the turbinates to enlarge.
- Infections: Turbinates enlarge with recurring upper respiratory tract infections such as sinusitis and viral infections.
- Environmental factors: Staying for a long time in places with polluted air and smoking affect the turbinates negatively and cause them to enlarge.
What Problems Can Turbinates Cause?
Excessive enlargement of the turbinates can cause a number of problems in the patient’s life. Together with a bony curvature in the nose, it causes difficulty breathing, nasal obstruction, headache, snoring during sleep and throat infections. Turbinate surgery aims to end these problems.
What are the Symptoms of Turbinate Enlargement?
The most common symptom of turbinate enlargement is nasal congestion. Patients have difficulty taking deep breaths. During sleep, they breathe deeply in and out through the mouth to take in more oxygen. Nasal obstruction also causes snoring. In addition, other symptoms include pressure in the forehead, a change in the sense of smell, nasal discharge and mild facial pain.
What is Turbinate Surgery and How is it Performed?
Turbinate surgery is performed under general or local anesthesia. One of the methods is turbinate removal surgery, in which the entire concha is cut and removed. Since filtration and humidification of the inhaled air would then be insufficient, complete removal is not performed unless necessary.
If there is no problem with the nasal bones, the turbinate reduction method is used. For this purpose, turbinate surgery is performed with laser, the latest technological development. A definitive result is obtained in a single session. During turbinate reduction surgery, the aim is to preserve the structure of the turbinate as much as possible.
The methods frequently used in turbinate (concha) operations are as follows:
- Reducing the turbinate with heat (laser or cauterization)
- Reducing the turbinates with radiofrequency waves (requires 2 sessions)
- Using a microdebrider to reduce the inner soft tissue of the turbinates
- Fracturing the turbinate bone and pushing it to the side, or reducing it
- Cutting the turbinates and removing part or all of them are methods commonly used in operations.
How is Laser Turbinate Surgery Performed?
The most frequently preferred option in turbinate operations is curettage and removal of the adenoid. As an option that is not preferred very often today, there is also the method of cutting and removing the adenoid. It is also possible to remove adenoid tissue by applying heat energy.
The adenoid may grow again after adenoid surgery. However, regrowth occurs more often in allergic children, in children operated on at an early age, or when the adenoid has not been completely removed.
In Which Cases is Turbinate Surgery Necessary?
Obstruction
- Surgery may be necessary in cases of persistent nasal obstruction and, as a result, breathing through the mouth.
- Dental problems, sleep problems caused by constantly breathing through the mouth during sleep, sleep apnea and problems in the upper palate arise from obstructive enlargement of the adenoid. In these cases, the adenoid is removed.
- Turbinate surgery becomes necessary as a result of problems caused by inability to breathe healthily, heart failure and insufficient oxygen intake through the mouth.
- Developmental disorders of the jaw and teeth are problems that arise in the upper palate. As a result, the upper jaw cannot develop sufficiently and is positioned further back than the lower jaw, and orthodontic problems may therefore arise.
Infections
Chronically recurring sinusitis and postnasal drip can cause attacks that make adenoid removal necessary. Continuous coughing, fever and sinusitis attacks are examples of this.
Chronically recurring middle ear infections are one of the conditions that make turbinate removal necessary and, in some cases, mandatory.
Other Conditions
Other conditions that lead to turbinate surgery are bad breath and the presence of a tumor.
How Long Does Turbinate Surgery Take?
Turbinate surgery performed by specialist physicians generally takes 15 or 20 minutes. However, if procedures such as aesthetic surgery, sinusitis surgery or nasal correction are added, it can take up to 2 hours.
What is Done After Turbinate Surgery?
After turbinate surgery, patients rest for about 8 hours and are then slowly helped to stand up. The walking distance is increased each time they get up. Patients can be discharged after 72 hours. In general there is no restriction of movement. However, headaches may occur when looking down. For this reason, patients are advised to drink plenty of water.
Immediately after the operation, packing and stitches will have been left inside the nose. The patient is asked to come for regular dressings. The packing is generally kept inside for 3 days. Physicians inform patients in detail about the healing rate and the stitches.
A patient who has had turbinate surgery should pay close attention to nasal hygiene. After discharge, the patient should be examined by the doctor at intervals of 3 or 4 weeks. Sprays can be used after turbinate surgery.
Is Nasal Packing Necessary After Turbinate Surgery?
Dissolvable nasal packs or cotton can be used after turbinate surgery. However, if a deviation procedure has not been performed together with the turbinate surgery, packing may not be necessary.
