The turbinates are three fleshy shelves on the side of the inside of the nose that serve to warm, moisturize, and filter inhaled air before it enters the lungs. If the turbinates become too enlarged from repeated infections, allergies, or other irritants, they can cause nasal blockage. This problem is called turbinate hypertrophy (enlarged turbinates).
If you have turbinate hypertrophy, you may be initially placed on a nasal steroid and have your allergies managed to reduce their size medically. If your turbinates persistently cause nasal obstruction, you may be a candidate for reducing the size of the turbinates surgically called partial turbinate reduction.
Partial Turbinate Reductions are performed through the nose without any scars on the outside of the nose or face. A small incision is made on the front of the turbinate and a small bone is removed causing the turbinate to collapse and reduce in size. Dr. Pasha does not remove the entire turbinate. The turbinate is critical for proper nasal breathing (warming, filtering, and moisturizing) therefore Dr. Pasha only reduces the size of the turbinate. He is careful to preserve the mucosa or lining of the turbinate to maintain the turbinate’s function in preventing nasal crusting.
The total time for this operation is 20-30 minutes and is performed using general anesthesia (while you are asleep). You should anticipate going home the same day unless other medical conditions complicate recovery. Since Dr. Pasha rarely uses packing, significant pain and discomfort usually resolves within the first 2-3 days.
Dr. Pasha routinely combines septoplasties and endoscopic sinus surgery with partial turbinate reductions to widen the nasal cavity and to allow access to the sinuses.
Enlarged turbinates may be diagnosed by using an endoscope to look further back in the nose. This procedure is done in the office after spraying the nose with a decongestant and anesthetic (numbing agent). This procedure is typically painless and only takes a few minutes. Cat Scans (a type of X-ray) may also reveal deviated nasal septums and enlarged turbinates.
The turbinates have a number of important functions to the nose. This includes:
- Filtering pollutants
- Warming inspired air
- Moisturizing inspired air
- Regulating air flow
Removal of the turbinates will compromise nasal function potentially causing a complication called empty nose syndrome. This syndrome can occur when the turbinates are removed to a point where they lose their function causing a dry, congested nose.
Dr. Pasha gives special regard to the function of turbinates and rarely if ever removes turbinates.
Yes, for select patients Dr. Pasha may also offer an in-office version of partial turbinate reduction. The in-office technique is not as “dramatic” as performing it in the operating room but does allow easy recovery and no time off work or school.
The operation itself is not painful since you are asleep for the procedure. Discomfort after the surgery varies widely. Generally speaking, one should anticipate a few days of discomfort with an additional one-week of soreness. Pain medications will be prescribed to reduce your discomfort.
You may return to work or school whenever comfortable, approximately 3-4 days. However, if your turbinate reduction is combined with a septoplasty, Dr. Pasha suggests taking one week off until after the splints are removed.
Turbinate reductions are safe with rare complications. The more common risk is nasal dryness and bleeding requiring nasal packing. The risk of general anesthesia as well as other rare complications will be discussed with you in the office.