Turbinate Reduction
Turbinate Reduction Surgical Procedure
Why Does Someone Need Turbinate Reduction?
Small, fleshy structures inside the nose called turbinates work like an air filter for the body. They cleanse and humidify the air that passes through the nostrils and enters the lungs.
Turbinates are found on both sides of the nasal cavity and are covered by a thick layer of vascular tissue and a mucus membrane. The inferior turbinate is the largest and sits toward the bottom of the nasal cavity. The middle turbinate is in the center of the nasal cavity. And the superior turbinate sits at the top of the nasal cavity.
The primary function of the turbinates is to direct airflow through the nasal cavity, and the soft tissue that covers them is responsible for humidifying, heating, and filtering the inhaled air. Humidifying the air and nasal cavity is important because it prevents the olfactory receptors, which are responsible for scent recognition, from becoming damaged.
The turbinates also work as the first line of defense for the immune system. At the first sign of microbial or chemical irritation, they will trigger an immune response to protect the body.
So, why would someone need turbinate reduction surgery?
If the turbinates are healthy and functioning as they should, they will do a good job of regulating airflow, moisture, and temperature inside the nasal cavity. However, if the turbinates become inflamed, enlarged, swollen, or even displaced, they can block the nasal passage, making it hard to breathe.
Not only can the turbinates make it difficult to breathe when they are not functioning properly, but they can also cause several other problems, such as headaches, sleep disorders, sinusitis, and chronic congestion.
It’s common for people to have occasional issues with their turbinates due to things like allergies, infections, seasonal changes, stress, hormonal changes, and medications. And many of these issues can be treated, or they will go away on their own.
However, more chronic and severe issues, such as severe allergies, chronic infections, and anatomical issues with the nose, can result in more permanent turbinate enlargement or displacement. When this occurs, turbinate reduction surgery may be the only option to fix the problem.
Turbinate reduction can also be used in combination with a septoplasty to help correct a deviated septum.
If swollen turbinates are making it hard to breathe through your nose, chat with us to find an ENT near you who can evaluate whether turbinate reduction could open things up.
What are the Pros and Cons of Turbinate Reduction?
All surgeries come with their risks, including turbinate reduction surgery. So it’s important for patients to consider both the pros and the cons to determine if the surgery is the right option for them.
The pros of turbinate reduction surgery include the following:
1. It’s an Outpatient Procedure or office based treatment
If your procedure is done in an outpatient setting you will be put under general anesthesia for turbinate reduction surgery, but it is still considered an outpatient procedure because you will wake up and go home the same day. This is ideal because it means you will have a faster recovery time and will be able to return to your normal activities within a few days. Office based treatment is even easier to do requiring less complicated anesthesia and less recovery with a quicker return to normal activity.
2. Improves Sleep
When the turbinates are not functioning properly, it can make it hard to breathe—especially at night—which can disrupt sleep, leading to chronic fatigue. People with turbinate problems can also develop sleep apnea. Thus, by getting the surgery, you can breathe better and sleep better, which is essential for maintaining your health.
3. Can Reduce Headache Frequency
Issues with the nasal cavity can also cause a build-up of pressure, which can lead to frequent headaches. So, by having the turbinates operated on, it can relieve that pressure, which will then alleviate the headaches.
4. Clears Chronic Nasal Congestion
Of course, one of the most obvious and irritating symptoms of turbinates issues is not being able to breathe normally. A chronic stuffy nose can be frustrating and cause other problems with the sinuses. So, by having the surgery, you can breathe easier and improve airflow.
Some cons of turbinate reduction surgery include:
1. Nosebleeds
In some cases, a turbinate reduction can disrupt the ability to humidify the nasal cavity. If this happens, it can make you more susceptible to nosebleeds. However, you can do other things to help increase the moisture in your nose, such as using nasal rinses and humidifiers in your home.
2. Chronic Dry Nose
If the turbinate reduction disrupts your body’s ability to humidify the air flowing into your nose, you can also experience frequent drying and crusting inside the nasal cavity, which can be irritating. Again, humidifiers can help, along with saline or sea salt rinses.
3. Empty Nose Syndrome
Some patients may need to have the entire turbinate removed. If this is the case, you will be unable to feel the sensation of air passing through the nasal cavity, which can be bothersome for some people. Unfortunately, there is no solution to this problem, but you will likely adjust over time.
What to Expect: What is Turbinate Reduction?
Turbinate reduction surgery is performed to decrease the size of the turbinates, or remove them entirely, to improve breathing. The procedure is only done if non-surgical treatments do not work to relieve symptoms.
How Much Does it Cost?
The cost of a turbinate reduction surgery can vary depending on how much tissue needs removing, how long the procedure takes, and anything else that may need to be performed in addition to the turbinate reduction, such as a septoplasty. If you have insurance, the cost will be significantly less, potentially only a few hundred dollars, or free, depending on your insurance plan.
Without insurance, a less invasive turbinate reduction surgery can cost up to $2,000. For more invasive turbinate surgeries, the cost can go up to $10,000 without insurance coverage.
What Happens Before Turbinate Surgery?
Pre-op instructions for turbinate reduction surgery can vary depending on the patient’s individual situation. However, some standard instructions you may receive from your doctor can include:
- Stop taking certain medications. This can include blood thinners like Aspirin or Coumadin or diabetic medications like insulin.
- Do not eat or drink the night before surgery.
- You might also be asked to come in for pre-op blood work or other tests based on your medical history.
What Happens During Turbinate Reduction Surgery?
The exact procedure performed during surgery can vary, as there are different methods for turbinate reduction. Your doctor's method will depend on your situation and what you need to be done.
Some methods may be performed to simply shrink the size of your turbinates, and other methods might involve removing some tissue and bone or even removing the entire turbinate. You might also only have the turbinates on one side of your nasal cavity operated on, or you might have a bilateral turbinate reduction if both sides are causing problems.
Some of the various methods for turbinate reduction surgery include:
Laser Treatment
Laser surgery is a common procedure used for turbinate reduction. This method uses a laser to shrink the turbinate cells from the inside, which reduces the size and volume.
Electrical Cauterization
With cauterization, an electric device is used to heat the turbinates, which causes scar tissue to form. This method can reduce the size of the turbinates and result in less inflammation.
Coblation-Assisted Reduction
Coblation-assisted reduction is a method that involves the use of a probe that emits a high-frequency, low-amplitude radio frequency energy, which ablates the turbinates and reduces the size.
Microdebrider-Assisted Submucous Reduction
This is a more invasive reduction method that reduces the turbinate bone without affecting the function of the mucous membrane on top of the turbinate.
Surgical Removal
In some cases, the entire turbinate or parts of it may need to be removed. With this method, the surgeon will cut into the turbinate to remove some or all of the structure. This process might also involve using a microdebrider to shave away some extra tissue around your turbinates to further open the nasal cavity.
Turbinate Reduction Recovery
Everyone’s recovery is different and will depend on the exact procedure used for the turbinate reduction surgery. The more invasive the surgery and the more tissue and bone that is removed, the longer the recovery time will be.
Immediately following the procedure, you will remain in the hospital or doctor’s office for a short period to make sure there are no issues or adverse side effects. Once the doctor gives you the okay, you can go home the same day, and they will give you instructions for at-home care, which may include some medications to help control the pain.
Generally, recovery is quick and not too painful. Most patients completely heal within three weeks. However, recovery can take three to six months for more invasive turbinate surgeries. And for up to a week after surgery, you may be required to use gauze in your nostrils to protect the surgical wounds.
You may be asked to avoid strenuous activities or refrain from blowing your nose for several weeks to prevent bleeding and swelling, depending on the surgery. You may also need to elevate your head while sleeping and avoid wearing clothing that must be pulled over your face and head to prevent irritating your nose.
Are There Side Effects?
All surgeries come with risks and potential side effects. For a minor turbinate reduction surgery, there will be fewer side effects. In contrast, with more invasive procedures, you are more likely to have more side effects that will also last longer.
Some of these side effects may include:
- Pain
- Swelling
- Nausea
- Drowsiness
- Bleeding
- Irritation
- Dryness
- Crusting
- Nosebleeds
To prevent the worst side effects, your doctor may recommend using humidifiers, nasal sprays, or vaseline. Just make sure to ask your doctor first before using a spray or vaseline inside your nose, as it could disrupt the healing process or dislodge tissue before it has fully healed. In some cases, the turbinates may even regrow, which may require you to undergo additional treatment or surgery.
When to Call Your Doctor
It is possible that after you are sent home, you could develop an infection or other complications. If this is the case, you may need to call your doctor or even go to the ER.
Signs that you have an infection or another serious complication can include the following:
- Difficulty breathing
- Extreme pain that is not tolerable
- Fever
- Excessive bleeding
- Inability to urinate ((A complication from general anesthesia)
- Unable to eat or drink without vomiting
What is the Goal of Turbinate Reduction?
Overall, the goal of turbinate reduction is to reduce the size of the turbinates without causing damage to surrounding tissue or without having to remove too much tissue or bone. The less tissue that is removed, the better. If too much tissue is removed, it may cause the nasal cavity to become very dry, which can lead to irritation, crustiness, and nosebleeds.
The goal is also to reduce the turbinates without regrowth happening to avoid needing additional surgeries. However, regrowth can still occur.
But in most cases, a turbinate reduction is a simple procedure that is often successful and alleviates symptoms, allowing patients to breathe easier. The more care you take to follow instructions after the surgery, the more likely you are to have a speedy and successful recovery.